Patient-Provider Relationships, HIV, and Adherence

MPH, Arlyn Apollo, MD,; Golub, Sarit A.; Wainberg, Milton L.; Indyk, Debbie

doi:10.1300/j010v42n03_13

Cited by 22 publications

(22 citation statements)

References 6 publications

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“…25 The importance of patientcentered care in engagement, retention, and adherence has been described in treatment settings. 30,31 Previous studies have shown that healthy MSM access healthcare less than the general male population. 32,33 Our study suggests that accessing PrEP may be a gateway for MSM to engage in regular HIV/STI testing, health monitoring, and other preventive services.…”

Section: Discussionmentioning

confidence: 99%

Participant Experiences and Facilitators and Barriers to Pill Use Among Men Who Have Sex with Men in the iPrEx Pre-Exposure Prophylaxis Trial in San Francisco

Gilmore

Liu

Koester

et al. 2013

AIDS Patient Care and STDs

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In 2010, the iPrEx study demonstrated efficacy of daily emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) pre-exposure prophylaxis (PrEP) in reducing HIV acquisition among men who have sex with men. Adherence to study product was critical for PrEP efficacy, and varied considerably, with FTC/TDF detection rates highest in the United States. We conducted a qualitative study to gain insights into the experiences of iPrEx participants in San Francisco (SF) where there was high confirmed adherence, to understand individual and contextual factors influencing study product use in this community. In 2009 and 2011, we conducted focus groups and in-depth interviews in 36 and 16 SF iPrEx participants, respectively. Qualitative analyses indicate that participants joined the study out of altruism. They had a clear understanding of study product use, and pill taking was facilitated by establishing or building on an existing routine. Participants valued healthcare provided by the study and relationships with staff, whom they perceived as nonjudgmental, and found client-centered counseling to be an important part of the PrEP package. This facilitated pill taking and accurate reporting of missed doses. Adherence barriers included changes in routine, side effects/intercurrent illnesses, and stress. Future PrEP adherence interventions should leverage existing routines and establish client-centered relationships/ environments to support pill taking and promote accurate reporting.

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Section: Discussionmentioning

confidence: 99%

Participant Experiences and Facilitators and Barriers to Pill Use Among Men Who Have Sex with Men in the iPrEx Pre-Exposure Prophylaxis Trial in San Francisco

Gilmore

Liu

Koester

et al. 2013

AIDS Patient Care and STDs

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“…Effective patient-clinician relationships appear to help patients overcome these challenges and achieve positive outcomes. High-quality interactions with clinicians improve HIV medication adherence [24, 25], satisfaction with care and health-related quality of life [26]. A general measure of relationship quality, feeling known as a person, is associated with better adherence and HIV viral suppression [27].…”

Section: Introductionmentioning

confidence: 99%

Clinician empathy is associated with differences in patient–clinician communication behaviors and higher medication self-efficacy in HIV care

Flickinger

Saha

Roter

et al. 2016

Patient Education and Counseling

101

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Objective We examined associations of clinicians’ empathy with patient-clinician communication behaviors, patients’ rating of care, and medication self-efficacy. Methods We analyzed 435 adult patients and 45 clinicians at four outpatient HIV care sites in the United States. Negative binomial regressions investigated associations between clinician empathy and patient-clinician communication, assessed using the Roter Interaction Analysis System (RIAS). Logistic regressions investigated associations between clinician empathy and patient ratings of clinician communication, overall satisfaction, and medication self-efficacy. Results Clinicians in the highest vs. lowest empathy tertile engaged in less explicitly emotional talk (IRR 0.79, p<0.05), while clinicians in the middle vs. lowest engaged in more positive talk (IRR 1.31, p<0.05), more questions (IRR 1.42, p<0.05), and more patient activating talk (IRR 1.43, p<0.05). Patients of higher empathy clinicians disclosed more psychosocial and biomedical information. Patients of clinicians in both the middle and highest (vs. lowest) empathy tertiles had greater odds of reporting highest medication self-efficacy (OR 1.80, 95% CI 1.16–2.80; OR 2.13, 95% CI 1.37–3.32). Conclusions Clinician empathy may be expressed through addressing patient engagement in care, by fostering cognitive, rather than primarily emotional, processing. Practice Implications Clinicians should consider enhancing their own empathic capacity, which may encourage patients’ self-efficacy in medication adherence.

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“…In some ways it marks the success of individual and collective struggles by lay people (and particularly women) for greater control over our bodies and lives (Mitchinson, 1998), struggles actively supported by social work practitioners and scholars (Apollo, Golub, Wainberg, & Indyk, 2006;Runfola, Levine, & Sherman, 2006). As alternative to governance by others, autonomy (self governance) certainly seems preferable.…”

Section: Introductionmentioning

confidence: 99%

Treatment Decision Making and Its Discontents

Sinding

Wiernikowski

2009

Social Work in Health Care

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Patient participation in treatment decision making is held as a virtue in clinical contexts, and has much to recommend it. Yet important questions have been raised about the assumptions underlying models of patient participation. Debates have arisen about the significance of medically defined risks and outcomes of treatment; the adequacy and relevance across social groups of the concept of autonomy; and the emphasis on the professional-patient dyad. This article contributes to the debate about treatment decision making with reference to a study focused on older women with cancer. Interviews with patients and cancer care professionals highlighted the salience to patients' treatment choices of experiential knowledge, social roles and responsibilities, and the health policy context. It appears that prevailing models of decision making may obscure patients' more typical decision processes as well as the social determinants of those choices.

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Patient-Provider Relationships, HIV, and Adherence

Cited by 22 publications

References 6 publications

Participant Experiences and Facilitators and Barriers to Pill Use Among Men Who Have Sex with Men in the iPrEx Pre-Exposure Prophylaxis Trial in San Francisco

Participant Experiences and Facilitators and Barriers to Pill Use Among Men Who Have Sex with Men in the iPrEx Pre-Exposure Prophylaxis Trial in San Francisco

Clinician empathy is associated with differences in patient–clinician communication behaviors and higher medication self-efficacy in HIV care

Treatment Decision Making and Its Discontents

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