HIV/Adhere^sm

Description of the HIV/Adhere A-CASI

The HIV/Adhere A-CASI includes the following sections:

Assessment of patients' regimen understanding Three day adherence assessment (dose-by-dose) Seven and thirty day adherence self report using VAS scale Reasons for missing doses Adherence intervention

Example regimen display in a "mediset" Is this how you are supposed to take your medications?   Morning Afternoon Evening 3TC/Epivir/ Lamivudine 150mg   AZT/Retrovir/ Zidovudine 300mg   Efavirenz/ Sustiva 600mg

3-day adherence assessment.	The patient reports the total number of doses missed over the past three days. The self-reported. The mediset metaphor continues in this section, as the patient clicks on the pills or doses missed.
VAS Scale estimates of adherence over the past seven and thirty days.	Clicking on a VAS (visual analog scale) records the patient estimate of seven and thirty day adherence. Some recent research suggests that a color-gradient scale (green - yellow - red) may elicit more accurate responses. You can choose the style of graphic image. Numbered VAS Scale Color VAS Scale
Reasons for missed doses.	When patients acknowledge missed doses, they are prompted to select their reasons for missing doses from a pre-defined list. If more than one reason is selected, a follow-up question asks about the primary reason for missing doses. The primary reason triggers tailored feedback messages during the intervention portion.
An adherence intervention	An increasing body of research suggests that individually tailored intervention feedback is more effective than generalized feedback. HIV/Adhere retains patients' responses. Each time a patient uses it, responses from the current and previous interviews are considered in tailoring feedback.
Patient report	The patient report includes the patient's regimen, adherence and risk category based on the patient's responses, the patient's most recent CD-4 and viral load lab test results, and a brief explanation, plus the computer-tailored feedback messages delivered during the assessment.

HIV/Adhere may be combined with additional questionnaires. Often HIV adherence assessments are accompanied by assessments for depression, alcohol/drug use and sexual risk.

HIV/Adhere was implemented with CASIC Builder™, a flexible browser-based platform for the development of medication and other health questionnaires.

The next page provides an example provider report.