Which Clinician Questions Elicit Accurate Disclosure of Antiretroviral Non-adherence When Talking to Patients?

AIDS Behav 2016 05;20(5):1108-15

Johns Hopkins University School of Medicine, Baltimore, MD, USA.

This study evaluated how clinicians assess antiretroviral (ARV) adherence in clinical encounters, and which questions elicit accurate responses. We conducted conversation analysis of audio-recorded encounters between 34 providers and 58 patients reporting ARV non-adherence in post-encounter interviews. Among 42 visits where adherence status was unknown by providers, 4 providers did not discuss ARVs (10 %), 6 discussed ARVs but did not elicit non-adherence disclosure (14 %), and 32 discussed ARVs which prompted disclosure (76 %). Questions were classified as: (1) clarification of medication ("Are you still taking the Combivir?"); (2) broad ("How's it going with your meds?"); (3) positively-framed ("Are you taking your medications regularly?"); (4) negatively-framed ("Have you missed any doses?"). Clinicians asked 75 ARV-related questions: 23 clarification, 12 broad, 17 positively-framed, and 23 negatively-framed. Negatively-framed questions were 3.8 times more likely to elicit accurate disclosure than all other question types (p < 0.0001). Providers can improve disclosure probability by asking directly about missed doses.

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Source
http://dx.doi.org/10.1007/s10461-015-1231-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840053PMC
May 2016
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