Psychological changes and patient quality of life

Amid the growing use of quality measures, patient-reported outcomes (PROs) should not be overlooked as a potential tool to improve clinical care, according to Dr Hal Martin, Director of Clinical Research at Gilead Sciences, San Francisco, California. In this second of a three-part series, Dr Martin discusses how PRO questionnaires can be used in practice to more accurately identify issues faced by people living with HIV (PLHIV).

Healthcare providers (HCPs) are often reluctant to use PROs routinely because they fear it will add to their workload rather than make them more efficient and effective. Furthermore, many HCPs who do spend time talking to PLHIV contend that they already understand their problems and do not need additional information from them.1

However, PLHIV contend with many psychological and psychosocial concerns: how to avoid putting others at risk of infection; how to manage disclosure of their HIV status to current and future sexual partners, family, work colleagues and others; discrimination from others on the basis of their HIV status, to name just a few. It is impractical to think that HCPs can fully understand the effect of a disease and/or treatment on the daily life of every person living with HIV.

In this aspect of care, PROs provide a means by which to fill a vital gap in our knowledge about outcomes and about whether interventions actually make a difference to people’s lives.

“PROs can dive more than a HCP can into how a person is feeling,” said Dr Martin.

To emphasis the limitations of open-ended questions and/or patient answers, Dr Martin used the example of assessing sleep issues in a typical consultation. If a person comments that they are having difficulty sleeping, then the information available to the HCP is very limited. However, asking the same question using a validated tool allows the HCP to identify whether it’s trouble getting to sleep; staying asleep; getting interrupted sleep or waking up in the morning.

“There’s just a lot of factors that PROs can get at that I think can cover more depth than just an interview,” he said.

View the interview with Hal Martin


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