Callon2016
| Callon2016 | |
|---|---|
| BibType | ARTICLE |
| Key | Callon2016 |
| Author(s) | Wynne Callon, Somnath Saha, P. Todd Korthuis, Ira B. Wilson, Richard D. Moore, Jonathan Cohn, Mary Catherine Beach |
| Title | Which clinician questions elicit accurate disclosure of antiretroviral non-adherence when talking to patients? |
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| Tag(s) | EMCA, AIDS, medication, Adherence, Physician-Patient Relations, Counseling, Medical |
| Publisher | |
| Year | 2016 |
| Language | English |
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| Month | |
| Journal | AIDS and Behavior |
| Volume | 20 |
| Number | 5 |
| Pages | 1108–1115 |
| URL | Link |
| DOI | 10.1007/s10461-015-1231-7 |
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Abstract
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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