RT Journal Article
SR Electronic
T1 Clinical outcomes of administering an ePROM of barriers to adherence to ART to people with HIV through a patient portal
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 6883
DO 10.1370/afm.22.s1.6883
VO 22
IS Supplement 1
A1 Chalati, MHD Amir
A1 Lessard, David
A1 Engler, Kim
A1 Cox, Joseph
A1 Costiniuk, Cecilia
A1 Lebouché, Bertrand
A1 Baradaran, Ashkan
A1 Hijal, Tarek
A1 Yuanchao
A1 de Pokomandy, Alexandra
YR 2024
UL http://www.annfammed.org/content/22/Supplement_1/6883.abstract
AB Context: Adherence to antiretrovirals (ART) by people with HIV (PWH) is crucial, however, many face obstacles that go undiscussed with health professionals. We used the patient portal (Opal) to administer the I-Score, a 7-item electronic patient-reported outcome measure (ePROM) of barriers to ART adherence.Objective: To describe patient and service-related outcomes of the I-Score intervention and outline adherence barrier management by physicians.Study Design Analysis: 6-month one-arm implementation pilot study.Setting: A hospital-based clinic in Montreal, Canada.Population: Adult PWH on ART, speaking French or English, owning a smartphone, willing to use the patient portal, with a history of adherence issues.Intervention/Instrument: Patients completed the I-Score on the patient portal up to two days before visits with their physician at Baseline (T1), 3 months (T2), and 6 months (T3). We collected patients’ sociodemographic information at T1, and HIV viral loads at T1 and T3. At each visit, patients reported ART adherence, and physicians completed a checklist of actions undertaken based on I-Score results.Outcome Measures: Patient outcomes at T1 and T3, included HIV viral load undetectability, mean scores for self-reported adherence (score of 1 to 5) and adherence barriers (score of 1 to 10) over the past month. For service outcomes, we report frequencies and proportions of clinical visits where physicians took actions based on I-Score results.Results: Out of 26/32 participants who completed the intervention, 11/26 (42%) were female; 14/26 (54%) aged ≥ 50 years; and 8/26 (31%) had an income below $19,999. Most patients (23/26) had an undetectable viral load at T1 and T3. Concerning domains of adherence barriers, mean scores decreased for: Thoughts/Feelings (T1=2.9/10 to T3=2.3/10), Habits/Activities (1.8;1.7), Medication (2.1;1.5), and Health (2.0;1.3), but increased for: Social (2.5;2.9) and Economic Situation (2.4;2.6), and Care (1.3;1.4). Average self-reported adherence increased from T1 (4.11) to T3 (4.19). Physicians ordered new tests for 10/26 (38%) patients, changed the medication plan of 7/26 (27%) patients, and referred14/26 (54%) patients to a specialist.Conclusions: Administering the I-Score on a patient portal is feasible and appears to improve patient and service outcomes, yet with slight fluctuations. Further research is recommended for a more robust understanding of its efficacy.