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

Objectives: Increasing 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 review.

Results:  Sixty-seven 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.