Developing an implementation blueprint: Lessons learned from integrating electronic patient-reported outcomes in HIV clinics in Alabama. PLoS One 2024;19(10):e0312782
Date
10/30/2024Pubmed ID
39475996Pubmed Central ID
PMC11524444DOI
10.1371/journal.pone.0312782Scopus ID
2-s2.0-85208117435 (requires institutional sign-in at Scopus site)Abstract
People living with HIV are disproportionately affected by depression, anxiety, and substance use which impede engagement with HIV treatment services and can increase risks of HIV-related morbidity and mortality. Capturing timely, accurate patient data at point of care is recommended to inform clinical decision-making and retain patients on the HIV care continuum. Currently, there is limited use of validated screening tools for substance use and mental health at the point of care in HIV clinics, even though people with HIV (PWH) have a high prevalence of these comorbidities. Even fewer clinics screen in a manner that encourages disclosure of stigmatized substance use, depression, and anxiety. Electronic patient-reported outcomes (ePROs) are an evidence-based modality to overcome such limitations by eliciting responses directly from patients via tablet, smartphone, or computer. To date, there is limited consensus on how to implement ePROs into non-academic settings and enhance uptake. Our team sought to address this gap by examining the implementation of ePROs, previously implemented in an academic clinic, to enhance screening and treatment of mental health (MH) and substance use at five Ryan White HIV/AIDS Program-funded clinics in Alabama. The ePROs were delivered through a multi-component intervention titled HIV + Service delivery and Telemedicine through Effective Patient Reported Outcomes (+STEP), which also provides targeted training to frontline clinicians, and resources for MH and substance use treatment for PWH without access to care. The objective of this study is to provide an implementation blueprint that can be tested and utilized in other HIV clinics to integrate ePROs and increase evidence-based screening for depression, anxiety, and substance use among PWH, as well as outline lessons learned from implementation to date. The findings from this study provide practical steps and advice based on our experience in implementing electronic patient-reported outcomes in HIV clinics in the US Deep South.
Author List
Gagnon KW, Burgan K, Mulrain M, Baral S, Cropsey K, Mugavero M, Eaton EAuthor
Kelly W. Gagnon PhD Assistant Professor in the Psychiatry and Behavioral Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AlabamaAmbulatory Care Facilities
Anxiety
Depression
Female
HIV Infections
Humans
Male
Patient Reported Outcome Measures
Substance-Related Disorders
