1
|
Rodkjaer LØ, Storgaard M, Sørensen NT, Schougaard LMV. Levels of health literacy among people living with HIV in outpatient care: a cross-sectional study from Denmark. AIDS Res Ther 2023; 20:59. [PMID: 37633910 PMCID: PMC10463697 DOI: 10.1186/s12981-023-00562-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 08/20/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Low health literacy (HL) among people living with HIV (PLWHIV) encounter more disease related complications, more difficulty understanding health-related information and low adherence. Considering that, the HL levels among PLWHIV needs to be further investigated. The objective of this study was to investigate the levels of HL and patient involvement among PLWHIV in an outpatient clinic in Denmark. A second objective was to examine differences in HL levels across socio-demographic characteristics. METHODS In 2019, a population of 682 PLWHIV from a Danish outpatient hospital clinic were enrolled in cross-sectional study. Patients who had a digital postbox received an electronic questionnaire including following domains; health literacy, patient involvement, and socio-demographic status. Health literacy was measured using the Health Literacy Questionnaire (HLQ) through scores on three subscales: social support for health (HLQ4), engaging with healthcare providers (HLQ6), and understanding health information (HLQ9). An unpaired t-test was used to investigate mean differences in the HLQ scores across socio-demographic variables. RESULTS A total of 338 (55%) patients responded to the questionnaire. The included participants demonstrated high levels of HLQ4 (mean = 4.2) and HLQ6 (mean = 4.2), but lower for HLQ9 (mean = 2.9). In total 70-80% reported being involved in decisions about their health. We found a positive association between high level of HL (HLQ9) and living with a partner and higher levels of HL (HLQ4, HLQ6, and HLQ9) and employment. CONCLUSION PLWHIV in a Danish out-patient care population were found to have high levels of HL despite differences in demographic characteristics. Further research is needed to examine the levels of HL among non-responders to develop HL approaches and strategies to meet the needs of individuals with different HL skills.
Collapse
Affiliation(s)
- Lotte Ørneborg Rodkjaer
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
- Research Centre for Patient Involvement, Central Denmark Region, Aarhus University, Aarhus, Denmark.
| | - Merete Storgaard
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | | | - Liv Marit Valen Schougaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Centre for Patient Involvement, Central Denmark Region, Aarhus University, Aarhus, Denmark
- Center for Patient-reported Outcomes, AmbuFlex, Gødstrup Hospital, Herning, Denmark
| |
Collapse
|
2
|
Hjollund NHI, Larsen LP, de Thurah AL, Grove BE, Skuladottir H, Linnet H, Friis RB, Johnsen SP, May O, Jensen AL, Hansen TK, Taarnhøj GA, Tolstrup LK, Pappot H, Ivarsen P, Dørflinger L, Jessen A, Sørensen NT, Schougaard LMV, Team TA. Patient-reported outcome (PRO) measurements in chronic and malignant diseases: ten years' experience with PRO-algorithm-based patient-clinician interaction (telePRO) in AmbuFlex. Qual Life Res 2023; 32:1053-1067. [PMID: 36639598 PMCID: PMC10063508 DOI: 10.1007/s11136-022-03322-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Patient-reported Outcome (PRO) measures may be used as the basis for out-patient follow-up instead of fixed appointments. The patients attend follow-up from home by filling in questionnaires developed for that specific aim and patient group (telePRO). The questionnaires are handled in real time by a specific algorithm, which assigns an outcome color reflecting clinical need. The specific questionnaires and algorithms (named solutions) are constructed in a consensus process with clinicians. We aimed to describe AmbuFlex' telePRO solutions and the algorithm outcomes and variation between patient groups, and to discuss possible applications and challenges. METHODS TelePRO solutions with more than 100 processed questionnaires were included in the analysis. Data were retrieved together with data from national registers. Characteristics of patients, questionnaires and outcomes were tabulated for each solution. Graphs were constructed depicting the overall and within-patient distribution of algorithm outcomes for each solution. RESULTS From 2011 to 2021, 29 specific telePRO solutions were implemented within 24 different ICD-10 groups. A total of 42,015 patients were referred and answered 171,268 questionnaires. An existing applicable instrument with cut-off values was available for four solutions, whereas items were selected or developed ad hoc for the other solutions. Mean age ranged from 10.7 (Pain in children) to 73.3 years (chronic kidney disease). Mortality among referred patients varied between 0 (obesity, asthma, endometriosis and pain in children) and 528 per 1000 patient years (Lung cancer). There was substantial variation in algorithm outcome across patient groups while different solutions within the same patient group varied little. DISCUSSION TelePRO can be applied in diseases where PRO can reflect clinical status and needs. Questionnaires and algorithms should be adapted for the specific patient groups and clinical aims. When PRO is used as replacement for clinical contact, special carefulness should be observed with respect to patient safety.
Collapse
Affiliation(s)
- Niels Henrik I Hjollund
- AmbuFlex - Center for Patient-Reported Outcomes, Central Denmark Region, Gødstrup Hospital, Herning, Denmark.
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Louise Pape Larsen
- AmbuFlex - Center for Patient-Reported Outcomes, Central Denmark Region, Gødstrup Hospital, Herning, Denmark
| | | | - Birgith Engelst Grove
- AmbuFlex - Center for Patient-Reported Outcomes, Central Denmark Region, Gødstrup Hospital, Herning, Denmark
| | | | - Hanne Linnet
- Department of Oncology, Gødstrup Hospital, Herning, Denmark
| | | | - Søren Paaske Johnsen
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ole May
- Department of Medicine, Gødstrup Hospital, Herning, Denmark
| | | | | | - Gry Assam Taarnhøj
- Department of Oncology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Lærke Kjær Tolstrup
- Department of Oncology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Per Ivarsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Anne Jessen
- AmbuFlex - Center for Patient-Reported Outcomes, Central Denmark Region, Gødstrup Hospital, Herning, Denmark
| | - Nanna Toxvig Sørensen
- AmbuFlex - Center for Patient-Reported Outcomes, Central Denmark Region, Gødstrup Hospital, Herning, Denmark
| | - Liv Marit Valen Schougaard
- AmbuFlex - Center for Patient-Reported Outcomes, Central Denmark Region, Gødstrup Hospital, Herning, Denmark
| | - The AmbuFlex Team
- AmbuFlex - Center for Patient-Reported Outcomes, Central Denmark Region, Gødstrup Hospital, Herning, Denmark
| |
Collapse
|
3
|
Astradsson A, Sørensen NT, Graversen AS, Nemeiko I, Bilgin-Freiert A, Stephansen LV, Einarsson HB, Schougaard LMV, Juhler M, Hansen TS. Hydroflex: Use of Patient Reported Outcomes in a Clinical Setting Among Patients with Hydrocephalus. World Neurosurg 2023; 169:e67-e72. [PMID: 36270591 DOI: 10.1016/j.wneu.2022.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE/BACKGROUND A patient-reported outcome (PRO) measure is defined as "any report of the status of a patient's health condition that comes directly from the patient without interpretation of the patient's response by a clinician or anyone else". PRO data are increasingly being used in health care to facilitate monitoring of symptoms, facilitate communication between patients and clinicians, facilitate early identification of problems, and reduce unnecessary outpatient appointments for stable patients. METHODS We have designed a PRO system specifically for hydrocephalus, a program named Hydroflex. The aim of Hydroflex is to use PRO measures to decide the need for clinical attention and let the patients report their need regarding a physical consultation. Patients receive questionnaires at home instead of having prescheduled appointments at the outpatient clinic. Based on an automated algorithm, the patients' PRO measures are ranked to help clinical decision-making. RESULTS In this paper, we describe the implementation and early experience of Hydroflex at our institution. CONCLUSIONS It is our belief that Hydroflex provides more continuity in the treatment of patients with hydrocephalus. Also, it provides for a more standardized follow-up scheme, and we postulate this will lead to improved patient satisfaction and involvement and fewer outpatient appointments. Also, Hydroflex is useful for quality control and prospective research.
Collapse
Affiliation(s)
- Arnar Astradsson
- Department of neurosurgery, Aarhus University Hospital, Aarhus, Denmark.
| | - Nanna Toxvig Sørensen
- AmbuFlex - Center for Patient-reported Outcomes, Central Denmark Region, Gødstrup Hospital, Herning, Denmark
| | | | - Ivona Nemeiko
- Department of neurosurgery, Aarhus University Hospital, Aarhus, Denmark
| | | | | | | | - Liv Marit Valen Schougaard
- AmbuFlex - Center for Patient-reported Outcomes, Central Denmark Region, Gødstrup Hospital, Herning, Denmark
| | - Marianne Juhler
- Department of neurosurgery, Aarhus University Hospital, Aarhus, Denmark
| | | |
Collapse
|