2034. Effects of Depression
on Patterns of Care, Adherence and Patient Satisfaction among HIV-Infected Men
CR Uphold, VA Rehabilitation Outcomes Research Center, H Jia, VA Rehabilitation Outcomes Research Center, LD Ried, College of Pharmacy, University of Florida, K Reid, VA Rehabilitation Outcomes Research Center, K Findley, North Florida/South Georgia Veterans Health System, PW Duncan, VA Rehabilitation Outcomes Research Center, University of Florida
evidence indicates that depression is often overlooked and inadequately treated
in the general population, leading to negative disease outcomes. The purposes of
this study were to explore the impact of depression in HIV infection by
examining the proportions of the depressed HIV patients who did not receive
mental health care and antidepressant drug therapy; determining their medical
care adherence status; and assessing their satisfaction status.
Methods: The design was a
descriptive, cross-sectional survey. The
sample consisted of 177 HIV-infected men attending the HIV/AIDS clinics at a VA
medical center, university clinic, or public health department.
Researchers reviewed medical records and interviewed subjects. The
following instruments were used to measure key variables: Center for
Epidemiologic Studies Depression Scale, Lorig Health Utilization Scale, Patient
Medication Adherence Questionnaire, and Patient Satisfaction Questionnaire.
Depression was defined as having >=16 depressive symptoms. Drug use and
appointment-keeping behavior were measured by self report and medical record
patients (38%) were classified as depressed.
Sixty-four percent of those depressed patients had not received any form
of mental health care within the last year and eighty-one percent of the
depressed patients had not received any type of antidepressant drug therapy.
No differences were found between the depressed and non-depressed
patients in medication adherence and clinic appointments maintenance.
Depressed patients had significantly lower rates of patient satisfaction
than the non-depressed patients (t-test=3.25, p=0.001).
Conclusions: Similar to
findings in patients with chronic diseases, the majority of HIV patients with
depression were not receiving current treatment. Depression affected patient
satisfaction, but not medical care and clinic appointment adherence.
Impact: Clinicians and policy makers need to be cognizant that depression is a prevalent problem in the HIV population. Further efforts need to be directed to screening and treating depression in the HIV population. Depression negatively affects consumer satisfaction, an important benchmark of quality of care.