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Aiyegbusi OL, Cruz Rivera S, Roydhouse J, Kamudoni P, Alder Y, Anderson N, Baldwin RM, Bhatnagar V, Black J, Bottomley A, Brundage M, Cella D, Collis P, Davies EH, Denniston AK, Efficace F, Gardner A, Gnanasakthy A, Golub RM, Hughes SE, Jeyes F, Kern S, King-Kallimanis BL, Martin A, McMullan C, Mercieca-Bebber R, Monteiro J, Peipert JD, Quijano-Campos JC, Quinten C, Rantell KR, Regnault A, Sasseville M, Schougaard LMV, Sherafat-Kazemzadeh R, Snyder C, Stover AM, Verdi R, Wilson R, Calvert MJ. Recommendations to address respondent burden associated with patient-reported outcome assessment. Nat Med 2024; 30:650-659. [PMID: 38424214 DOI: 10.1038/s41591-024-02827-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/23/2024] [Indexed: 03/02/2024]
Abstract
Patient-reported outcomes (PROs) are increasingly used in healthcare research to provide evidence of the benefits and risks of interventions from the patient perspective and to inform regulatory decisions and health policy. The use of PROs in clinical practice can facilitate symptom monitoring, tailor care to individual needs, aid clinical decision-making and inform value-based healthcare initiatives. Despite their benefits, there are concerns that the potential burden on respondents may reduce their willingness to complete PROs, with potential impact on the completeness and quality of the data for decision-making. We therefore conducted an initial literature review to generate a list of candidate recommendations aimed at reducing respondent burden. This was followed by a two-stage Delphi survey by an international multi-stakeholder group. A consensus meeting was held to finalize the recommendations. The final consensus statement includes 19 recommendations to address PRO respondent burden in healthcare research and clinical practice. If implemented, these recommendations may reduce PRO respondent burden.
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Affiliation(s)
- Olalekan Lee Aiyegbusi
- Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC), University Hospital Birmingham and University of Birmingham, Birmingham, UK.
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) West Midlands, University of Birmingham, Birmingham, UK.
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK.
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.
| | - Samantha Cruz Rivera
- Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
| | - Jessica Roydhouse
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Department of Health Services Policy and Practice, Brown University School of Public Health, Providence, RI, USA
| | | | - Yvonne Alder
- Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Nicola Anderson
- Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC), University Hospital Birmingham and University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) West Midlands, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Vishal Bhatnagar
- Oncology Center of Excellence, US Food and Drug Administration, Silver Spring, MD, USA
| | | | | | | | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Philip Collis
- Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Alastair K Denniston
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC), University Hospital Birmingham and University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Adrian Gardner
- The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
- Aston University, Birmingham, UK
| | | | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sarah E Hughes
- Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC), University Hospital Birmingham and University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) West Midlands, University of Birmingham, Birmingham, UK
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
| | - Flic Jeyes
- Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | | | | | - Christel McMullan
- Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
| | - Rebecca Mercieca-Bebber
- The NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | - John Devin Peipert
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Juan Carlos Quijano-Campos
- William Harvey Research Institute, Queen Mary University of London, London, UK
- St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | | | | | | | | | | | | | - Claire Snyder
- Johns Hopkins Schools of Medicine and Public Health, Baltimore, MD, USA
| | - Angela M Stover
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Rav Verdi
- Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Roger Wilson
- Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Cancer Research Advocacy Forum, London, UK
| | - Melanie J Calvert
- Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC), University Hospital Birmingham and University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) West Midlands, University of Birmingham, Birmingham, UK
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
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Key considerations to reduce or address respondent burden in patient-reported outcome (PRO) data collection. Nat Commun 2022; 13:6026. [PMID: 36224187 PMCID: PMC9556436 DOI: 10.1038/s41467-022-33826-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022] Open
Abstract
Patient-reported outcomes (PROs) are used in clinical trials to provide evidence of the benefits and risks of interventions from a patient perspective and to inform regulatory decisions and health policy. The collection of PROs in routine practice can facilitate monitoring of patient symptoms; identification of unmet needs; prioritisation and/or tailoring of treatment to the needs of individual patients and inform value-based healthcare initiatives. However, respondent burden needs to be carefully considered and addressed to avoid high rates of missing data and poor reporting of PRO results, which may lead to poor quality data for regulatory decision making and/or clinical care. The collection of patient-reported outcomes (PROs) may capture patients’ assessments of their health status. Here authors highlight PRO-specific issues that should be considered to minimise respondent burden in clinical trials and routine care.
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Hood-Medland EA, Stewart SL, Nguyen H, Avdalovic M, MacDonald S, Zhu SH, Mayoral A, Tong EK. Health System Implementation of a Tobacco Quitline eReferral. Appl Clin Inform 2019; 10:735-742. [PMID: 31578046 PMCID: PMC6774758 DOI: 10.1055/s-0039-1697593] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/02/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Proactive referrals through electronic orders (eReferrals) can increase patient connection with tobacco quitlines. More information is needed on "real-world" implementation of electronic health record tools to promote tobacco cessation while minimizing provider burden. OBJECTIVES This paper examines the health system implementation of an eReferral to a tobacco quitline without best practice alerts in primary care, specialty, and hospital settings in an academic health system. METHODS This is a prospective implementation study of a health system tobacco eReferral to a state quitline that was completed with an approach to minimize provider cognitive burden. Data are drawn from electronic health record data at University of California, Davis Health Systems (March 2013-February 2016). RESULTS Over 3 years, 16,083 encounters with smokers resulted in 1,137 eReferral orders (7.1%). Treatment reach was 1.6% for quitline services and 2.3% for outpatient group classes. While the group classes were offered to outpatient smokers, the eReferral order was included in an outpatient order set and eventually an automated inpatient discharge order set; no provider alerts were implemented. Referrals were sustained and doubled after inpatient order set implementation. Among all first time eReferral patients, 12.2% had a 6 to 12 month follow-up visit at which they were documented as nonsmoking. CONCLUSION This study demonstrates a quitline eReferral order can be successfully implemented and sustained with minimal promotion, without provider alerts and in conjunction with group classes. Reach and effectiveness were similar to previously described literature.
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Affiliation(s)
- Eve Angeline Hood-Medland
- Department of Internal Medicine, University of California, Davis in Sacramento, California, United States
| | - Susan L. Stewart
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis in Sacramento, California, United States
| | - Hien Nguyen
- Department of Internal Medicine, University of California, Davis in Sacramento, California, United States
| | - Mark Avdalovic
- Department of Internal Medicine, University of California, Davis in Sacramento, California, United States
| | - Scott MacDonald
- Department of Clinical Informatics, University of California, Davis in Sacramento, California, United States
| | - Shu-Hong Zhu
- Department of Family Medicine, Moores Cancer Center, University of California, San Diego in San Diego, California, United States
| | - Antonio Mayoral
- Department of Family Medicine, Moores Cancer Center, University of California, San Diego in San Diego, California, United States
| | - Elisa K. Tong
- Department of Internal Medicine, University of California, Davis in Sacramento, California, United States
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Brown W, Sheinfil A, Lopez-Rios J, Giguere R, Dolezal C, Frasca T, Lentz C, Balán IC, Rael C, Cruz Torres C, Crespo R, Febo I, Carballo-Diéguez A. Methods, system errors, and demographic differences in participant errors using daily text message-based short message service computer-assisted self-interview (SMS-CASI) to measure sexual risk behavior in a RCT of HIV self-test use. Mhealth 2019; 5:17. [PMID: 31380409 PMCID: PMC6624350 DOI: 10.21037/mhealth.2019.06.01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/30/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Assessment of sexual risk behavior is crucial to HIV prevention trials. Currently, there are no biomarkers or objective measures to detect and characterize sexual risk behavior; therefore, we must rely on self-reports. Self-report accuracy may be improved by collecting data in real-time. Our objective was to demonstrate how a text message-based short message service computer-assisted self-interview (SMS-CASI) system can collect daily sexual risk behavior data. METHODS During the course of a 2-arm randomized controlled trial, confidential daily SMS-CASI was used to assess sexual risk behavior over three months for participants using only condoms in the control condition and using condoms and HIV self-tests to test themselves and their non-monogamous sexual partner over six months for participants in the intervention condition (total N=272). Active monitoring of participants responses and data cleaning took place concurrently with trial execution. Descriptive statistics were used to examine frequencies related to system functionality, participant reporting, system errors, communication patterns, and overall feasibility of using the SMS-CASI system for reporting sexual risk behavior. RESULTS The SMS-CASI system processed 272,565 messages. In addition, 87 classifications of metadata were collected, for a total of 22,895,460 different data points. Types of messages included these sent (N=171,749; 63.01%) to participants, received (N=100,646; 36.93%) from participants, and failed (N=168; 0.06%) to be sent. Most errors (N=1,858) were due to system malfunctions (N=535; 28.79%) or participants' mistakes (N=1,289; 69.38%). Participant errors included: wrong password, incomplete surveys, and invalid response. The highest error rates by demographic characteristics were by age among older participants [ages 30-39; 383 errors (29.71%), and 40-69; 545 errors (42.28%)] and by race among Hispanic/Latino participants [487 errors (37.78%)]. CONCLUSIONS The SMS-CASI system was effective at confidentially collecting sexual risk behavior data on a daily basis, potentially contributing to reduced recall and social desirability bias. This study provides methodological examples and data demonstrating how SMS-CASI can be used for sexual health data collection.
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Affiliation(s)
- William Brown
- Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, Division of General Internal Medicine, Department of Medicine, School of Medicine, University of California San Francisco, San Francisco, CA, USA
- Bakar Computational Health Science Institute, University of California San Francisco, San Francisco, CA, USA
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Alan Sheinfil
- Department of Psychology, Syracuse University, Syracuse, USA
| | - Javier Lopez-Rios
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, New York, NY, USA
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Rebecca Giguere
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Timothy Frasca
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Cody Lentz
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Iván C. Balán
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Christine Rael
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Catherine Cruz Torres
- Department of Pediatrics, University of Puerto Rico Medical Sciences Campus, San Juan, USA
| | - Raynier Crespo
- Department of Pediatrics, University of Puerto Rico Medical Sciences Campus, San Juan, USA
| | - Irma Febo
- Department of Pediatrics, University of Puerto Rico Medical Sciences Campus, San Juan, USA
| | - Alex Carballo-Diéguez
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, New York, NY, USA
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Satterfield JM, Gregorich SE, Kalkhoran S, Lum PJ, Bloome J, Alvarado N, Muñoz RF, Vijayaraghavan M. Computer-Facilitated 5A's for Smoking Cessation: A Randomized Trial of Technology to Promote Provider Adherence. Am J Prev Med 2018; 55:35-43. [PMID: 29929682 PMCID: PMC6020838 DOI: 10.1016/j.amepre.2018.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 03/07/2018] [Accepted: 04/02/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Although evidence-based, the 5A's (Ask, Advise, Assess, Assist, and Arrange) for smoking cessation are often incompletely delivered by primary care providers. This study examines whether a computer tablet 5A's intervention improves primary care provider adherence to the 5A's. STUDY DESIGN Cluster RCT. SETTING/PARTICIPANTS All primary care providers in three urban, adult primary care clinics were randomized for participation. Any English- or Spanish-speaking patient with a primary care appointment who had smoked >100 lifetime cigarettes and at least one cigarette in the past week was eligible. INTERVENTION A cluster RCT comparing computer-facilitated 5A's with usual care assessed effects on provider adherence to each of the 5A's as determined by patient report. Intervention subjects used a computer tablet to complete the 5A's immediately before a primary care appointment. A tailored, patient handout and a structured, clinician guide were generated. Data were collected in 2014-2015 and analyzed in 2016-2017. MAIN OUTCOME MEASURES Provider adherence to the 5A's. RESULTS Providers (N=221) saw 961 patients (n=412 intervention, n=549 control) for a total of n=1,340 encounters with n=1,011 completed post-visit interviews (75.4% completion). Intervention providers had significantly higher odds of completing Assess (AOR=1.32, 95% CI=1.02, 1.73) and Assist (AOR=1.45, 95% CI=1.08, 1.94). When looking at first study visits only, intervention providers had higher odds for Arrange (AOR=1.72, 95% CI=1.23, 2.40) and all 5A's (AOR=2.04, 95% CI=1.35, 3.07) but study visit did not influence receipt of the other 5A's. CONCLUSIONS A computer-facilitated 5A's delivery model was effective in improving the fidelity of provider-delivered 5A's to diverse primary care patients. This relatively low-cost, time-saving intervention has great potential for smoking cessation and other health behaviors. Future studies should identify ways to promote and sustain technology implementation. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT02046408.
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Affiliation(s)
- Jason M Satterfield
- Division of General Internal Medicine, University of California San Francisco, San Francisco, California.
| | - Steven E Gregorich
- Division of General Internal Medicine, University of California San Francisco, San Francisco, California
| | - Sara Kalkhoran
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Paula J Lum
- Division of HIV, Infectious Disease and Global Medicine, University of California San Francisco, San Francisco, California
| | - Jessica Bloome
- Division of HIV, Infectious Disease and Global Medicine, University of California San Francisco, San Francisco, California
| | - Nicholas Alvarado
- Division of General Internal Medicine, University of California San Francisco, San Francisco, California
| | - Ricardo F Muñoz
- Department of Psychiatry, University of California San Francisco, San Francisco, California; Institute for International Internet Interventions for Health, Palo Alto University, Palo Alto, California
| | - Maya Vijayaraghavan
- Division of General Internal Medicine, University of California San Francisco, San Francisco, California
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Morina N, Ewers SM, Passardi S, Schnyder U, Knaevelsrud C, Müller J, Bryant RA, Nickerson A, Schick M. Mental health assessments in refugees and asylum seekers: evaluation of a tablet-assisted screening software. Confl Health 2017; 11:18. [PMID: 29026438 PMCID: PMC5623980 DOI: 10.1186/s13031-017-0120-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/22/2017] [Indexed: 11/12/2022] Open
Abstract
Background Mental health problems resulting from persecution and forced migration are very common among refugees and asylum seekers and evolve into a major public health challenge in hosting societies. Language barriers often prevent timely access to appropriate health care, leading to chronic trajectories and abortive social integration. Tools for multilingual screening and assessment could be of great benefit for this particularly vulnerable population as well as for policy makers. This study aimed at testing the reliability, feasibility and usability of the Multi-Adaptive Psychological Screening Software (MAPSS), a newly developed Audio Computer-Assisted Self-Interview Software (ACASI) for touchscreen devices, for screening purposes in a clinical setting. Methods In a randomized cross-over design including both MAPSS and paper-pencil clinician-administered interviews, 30 treatment-seeking refugees completed clinical measures and a feasibility questionnaire to rate the user interface of MAPSS. Five professionals performed given tasks in MAPSS and completed usability questionnaires for the administration interface. Results Results showed no differences between the two assessment modalities with regard to symptom scores. The findings suggest good feasibility and usability of MAPSS in traumatized refugees. The administration via MAPSS was significantly shorter than the paper-pencil interview. Conclusion MAPSS may be a cost-effective, flexible and valid alternative to interpreter-based psychometric screening and assessment.
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Affiliation(s)
- Naser Morina
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
| | - Simon M Ewers
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
| | - Sandra Passardi
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
| | - Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
| | - Christine Knaevelsrud
- Department of Clinical Psychological Intervention, Freie Universität, Berlin, Germany
| | - Julia Müller
- Psychiatric Services Thurgau, CH-8596 Münsterlingen, Switzerland
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, N.S.W. 2052 Australia
| | - Angela Nickerson
- School of Psychology, University of New South Wales, Sydney, N.S.W. 2052 Australia
| | - Matthis Schick
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
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Morales-Estrella JL, Ciftci FD, Trick WE, Hinami K. Physical symptoms screening for cardiopulmonary complications of obesity using audio computer-assisted self-interviews. Qual Life Res 2017; 26:2085-2092. [DOI: 10.1007/s11136-017-1549-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 12/24/2022]
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Raimondo M, Facco G, Regine V, Pupella S, Grazzini G, Suligoi B. HIV-positive blood donors unaware of their sexual at-risk behaviours before donation in Italy. Vox Sang 2015; 110:134-42. [PMID: 26414961 DOI: 10.1111/vox.12328] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 07/23/2015] [Accepted: 08/03/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Despite the procedures adopted for the selection of blood donors, in Italy the HIV prevalence per 100 000 repeat tested donors (RTD) and first-time tested donors (FTD) is high compared to most other Council of Europe member states. To evaluate the effectiveness of predonation procedures, we studied both the characteristics and the undisclosed risk behaviours of HIV-positive donors. MATERIALS AND METHODS We analysed the data from the Italian blood donor surveillance system in 2009, 2010 and 2011. Based on the postdonation interview, HIV-positive donors were classified by risk behaviour (heterosexual, MSM, 'non-sexual' and 'not determined') and by time elapsed from risk behaviour to donation. In Italy, the temporary deferral for exposure to behaviour at risk is 4 months. RESULTS In the postdonation interview, 113 HIV-positive donors (32·4%), who denied at-risk behaviours in the predonation selection, reported sexual risk behaviours <4 months prior to donation; they were predominantly males (84·1%) and RTD (63·7%). The main reason for not having reported the risk behaviour in the predonation selection was 'not realizing having engaged in at-risk behaviour' (66·4%). CONCLUSION These findings underline the need for more comprehensible educational material, a clearer predonation questionnaire, and effective information campaigns to improve the awareness of HIV sexual risk behaviours among blood donors.
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Affiliation(s)
- M Raimondo
- National AIDS Unit, National Institute of Health, Rome, Italy
| | - G Facco
- National Blood Centre, National Institute of Health, Rome, Italy
| | - V Regine
- National AIDS Unit, National Institute of Health, Rome, Italy
| | - S Pupella
- National Blood Centre, National Institute of Health, Rome, Italy
| | - G Grazzini
- National Blood Centre, National Institute of Health, Rome, Italy
| | - B Suligoi
- National AIDS Unit, National Institute of Health, Rome, Italy
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