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Objective: To determine whether patients could self-report physical and mental health assessments in the waiting room and whether these assessments would be associated with modified Rankin Scale (mRS) and Quality of Life in Epilepsy (QOLIE-10) scores.Methods: We offered iPad-based surveys to consecutive adult neurology patients at check-in to collect patient-reported outcome measures (PROMs). We collected demographic and clinical data on 6,075 patients through survey or administrative claims and PROMs from participating patients. We compared demographic characteristics of participants and nonparticipants and tested associations between physical and mental health scores and mRS and QOLIE-10.Results: Of 6,075 patients seen by neurologists during the study period, 2,992 (49.3%) participated in the survey. Compared to nonparticipating patients, participating patients more often were privately insured (53.5% vs 42.7%, p , 0.01), married (51.5% vs 47.9%, p , 0.01), and seen in general neurology (nonsubspecialty) clinics (53.1% vs 46.6%, p , 0.01) and more likely to report English as their preferred language (50.1% vs 38.4%, p , 0.01). Participating patients had a mean physical health T score of 28.7 (SD 15) and mental health T score of 33 (SD 15), which were 3 and 2 SD worse than the average for the US general population, respectively.

ObjectiveMany effective medical therapies are available for treating neurological diseases, but these therapies tend to be expensive and adherence is critical to their effectiveness. We used patient-reported data to examine the frequency and determinants of financial barriers to medication adherence among individuals treated for neurological disorders.Patients and methodsPatients completed cross-sectional surveys on iPads as part of routine outpatient care in a neurology clinic. Survey responses from a 3-month period were collected and merged with administrative sources of demographic and clinical information (eg, insurance type). We explored the association between patient characteristics and patient-reported failure to refill prescription medication due to cost in the previous 12 months, termed here as “nonadherence”.ResultsThe population studied comprised 6075 adults who were presented between July and September 2015 for outpatient neurology appointments. The mean age of participants was 56 (standard deviation: 18) years, and 1613 (54%) were females. The patients who participated in the surveys (2992, 49%) were comparable to nonparticipants with respect to gender and ethnicity but more often identified English as their preferred language (94% vs 6%, p<0.01). Among respondents, 9.8% (n=265) reported nonadherence that varied by condition. These patients were more frequently Hispanic (16.7% vs 9.8% white, p=0.01), living alone (13.9% vs 8.9% cohabitating, p<0.01), and preferred a language other than English (15.3% vs 9.4%, p=0.02).ConclusionOverall, the magnitude of financial barriers to medication adherence appears to vary across neurological conditions and demographic characteristics.

Background Men who have sex with men (MSM) on antiretroviral therapy (ART) are at risk for multimorbidity as life expectancy increases. Simulation models can project population sizes and age distributions to assist with health policy planning. Methods We populated the CEPAC-US model with CDC data to project the HIV epidemic among MSM in the US. The PEARL model was predominantly informed by NA-ACCORD data (2009-2017). We compared projected population sizes and age distributions of MSM receiving ART (2021-2031) and investigated how parameters and assumptions affected results. Results We projected an aging and increasing population of MSM on ART: CEPAC-US: mean ± SD age, 48.6 ± 13.7y [2021] vs. 53.9 ± 15.0y [2031]; PEARL: 46.7 ± 13.2y vs. 49.2 ± 14.6y. We projected 548,800 MSM on ART (147,020 ≥ 65y) in 2031 (CEPAC-US) and 599,410 (113,400 ≥ 65y) (PEARL). Compared with PEARL, CEPAC-US projected a smaller population of MSM on ART by 2031 and a slower increase in population size, driven by higher estimates of disengagement in care and mortality. Conclusion Findings from two structurally distinct microsimulation models suggest that the MSM population receiving ART in the US will increase and age over the next decade. Subgroup-specific data regarding engagement in care and mortality can improve projections and inform health care policy planning.