Mental Health Screening Practices Among Primary Care Providers in High HIV Burden Areas of the South: Does Having Patients with HIV Matter?

Gaines, Malendie; Duke, Chris; Henny, Kirk D.

doi:10.1007/s11414-020-09719-z

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…Results from this study indicate that, similar to other settings and despite the awareness of physicians in hospital settings in Spain regarding the high prevalence and impact of NPCs in people with HIV, NPCs remain underdiagnosed [12–14]. Detection of NPCs is the first step to providing appropriate mental health care to people with HIV [1].…”

Section: Discussionmentioning

confidence: 91%

Perception of HIV physicians in Spain towards diagnosis and management of neuropsychiatric comorbidities in people with HIV

2022

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Objectives Despite the importance of neuropsychiatric comorbidities (NPCs) in people with HIV, the degree of physician compliance with recommendations for diagnosis and management is unknown. This study assessed the perceptions, knowledge, skills, and attitudes of physicians regarding the diagnosis and management of NPCs in people with HIV in hospital settings in Spain. Methods This was a cross‐sectional study including non‐psychiatrist HIV specialist physicians responsible for antiretroviral therapy (ART) prescription and clinical care of ≥50 people with HIV/month, who completed an online survey of 34 questions. Results The 115 physicians who completed the survey (totally) agreed that assessing mental health was relevant (97.4%) and that NPCs were underdiagnosed (76.6%) and were very/fairly sensitized (67.8%). However, they reported receiving little/no training on the detection of NPCs (64.3%). Physicians considered that patients underreported NPCs (53.9%) and that alcohol (94.8%), recreational substances (97.4%), and tobacco consumption (95.6%) were (very) relevant. Physicians agreed that NPCs were difficult to identify (52.2%) and that few tools were available (53.0%) and failed to use questionnaires (79.1%) and follow guidelines (77.4%) for the detection of NPCs. The main reasons precluding appropriate diagnosis and evaluation were lack of proactive attitudes and specific training and limited visit time. Upon detection of NPCs, physicians referred patients to the in‐house psychiatry/psychology centre (61.7%), adjusted ART to minimize interactions (96.5%), and managed NPCs in conjunction with mental health professionals (71.3%). Conclusions Physicians in hospital settings in Spain were aware of the relevance of NPC diagnosis and their underdiagnosis. However, they still failed to routinely evaluate NPCs, follow guideline recommendations, and use questionnaires, highlighting opportunities for improved NPC detection and management in people with HIV.

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Section: Discussionmentioning

confidence: 91%

Perception of HIV physicians in Spain towards diagnosis and management of neuropsychiatric comorbidities in people with HIV

2022

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“…Anxiety is also common but has been under investigated relative to depression [8,9]. Routine screening is essential for identifying these comorbidities [10][11][12][13], but is often underutilized due to lack of resources, time constraints, and stigma [14,15]. When screening does occur, there is variability in question content, frequency, and documentation by providers [16,17], and patients often underreport symptoms, particularly alcohol and other drug use problems [15,18].…”

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confidence: 99%

Patient and provider perspectives on self-administered electronic substance use and mental health screening in HIV primary care

Lea

Altschuler

Leibowitz

et al. 2022

Addict Sci Clin Pract

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Background Substance use disorders, depression and anxiety disproportionately affect people with HIV (PWH) and lead to increased morbidity and mortality. Routine screening can help address these problems but is underutilized. This study sought to describe patient and provider perspectives on the acceptability and usefulness of systematic electronic, self-administered screening for tobacco, alcohol, other substance use, and mental health symptoms among patients in HIV primary care. Methods Screening used validated instruments delivered pre-appointment by both secure messaging and clinic-based tablets, with results integrated into the electronic health record (EHR). Qualitative analysis of semi-structured interviews with 9 HIV primary care providers and 12 patients in the 3 largest HIV primary care clinics in the Kaiser Permanente Northern California health system who participated in a clinical trial evaluating computerized screening and behavioral interventions was conducted. Interviews were audio-recorded and transcribed. A thematic approach was utilized for coding and analysis of interview data using a combination of deductive and inductive methods. Results Four key themes were identified: (1) perceived clinical benefit of systematic, electronic screening and EHR integration for providers and patients; (2) usefulness of having multiple methods of questionnaire completion; (3) importance of the patient–provider relationship to facilitate completion and accurate reporting; and (4) barriers, include privacy and confidentiality concerns about reporting sensitive information, particularly about substance use, and potential burden from repeated screenings. Conclusions Findings suggest that electronic, self-administered substance use and mental health screening is acceptable to patients and may have clinical utility to providers. While offering different methods of screening completion can capture a wider range of patients, a strong patient–provider relationship is a key factor in overcoming barriers and ensuring accurate patient responses. Further investigation into facilitators, barriers, and utility of electronic screening for PWH and other high-priority patient populations is indicated. Trial registration ClinicalTrials.gov, NCT03217058. Registered 13 July 2017, https://clinicaltrials.gov/ct2/show/NCT03217058

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HIV and Mental Health Services in the US South: A Meso Analysis

Ali

Stanton

Keo

et al. 2022

Community Ment Health J

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Mental Health Screening Practices Among Primary Care Providers in High HIV Burden Areas of the South: Does Having Patients with HIV Matter?

Cited by 3 publications

References 18 publications

Perception of HIV physicians in Spain towards diagnosis and management of neuropsychiatric comorbidities in people with HIV

Perception of HIV physicians in Spain towards diagnosis and management of neuropsychiatric comorbidities in people with HIV

Patient and provider perspectives on self-administered electronic substance use and mental health screening in HIV primary care

HIV and Mental Health Services in the US South: A Meso Analysis

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