title: Development and field testing of an HIV medication touch screen computer patient adherence tool with telephone-based, targeted adherence counseling.
abstract: BACKGROUND
  HIV medication nonadherence is a major problem, yet many providers lack the time and training to carefully ask patients about their adherence.
  
  
  OBJECTIVE
  To design and pilot a technology-assisted intervention, for use in clinical settings, to identify nonadherent patients.
  
  
  METHODS
  The intervention uses audio computer-assisted self-interview (ACASI) to improve the assessment of adherence and medication-related problems. Patients completed a touch screen computer ACASI which generated graphic clinician and patient reports for discussion during the clinical encounter.
  
  
  RESULTS
  72 patients and 11 providers participated in this study. The patients easily completed the ACASI. Adherence was 63% (3-day) and 47% (30-day). Using the ACASI, 22% of patients identified themselves as nonadherent, when their providers perceived them as adherent.
  
  
  CONCLUSIONS
  This ACASI-based intervention is easy to use and helps identify nonadherence. The pilot test engendered enhancements including the addition of phone-based adherence counseling. A larger trial is underway to evaluate whether the intervention leads to improved HIV-related outcomes.
authors.affiliation: VA QUERI Program and Center for Health Quality, Outcomes and Economic Research, VA New England Healthcare System, Bedford, MA, USA.
authors.forename: D Keith
authors.initials: DK
authors.lastname: McInnes
authors.forename: Hélène
authors.initials: H
authors.lastname: Hardy
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Goetz
authors.forename: Paul R
authors.initials: PR
authors.lastname: Skolnik
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Brewster
authors.forename: Roger H
authors.initials: RH
authors.lastname: Hofmann
authors.forename: Allen L
authors.initials: AL
authors.lastname: Gifford
mesh_terms: D000293:Adolescent; D000328:Adult; D003376:Counseling / Q000379:methods*; D004360:Drug Therapy, Computer-Assisted / Q000295:instrumentation* / Q000379:methods*; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D050316:Medical Order Entry Systems; D055118:Medication Adherence; D008875:Middle Aged; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D013689:Telephone; D055815:Young Adult