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Patient and Provider-Reported Symptoms in the Post-cART Era

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Abstract

Prior research has consistently demonstrated that providers often under recognize symptoms. However, this research was limited by the different ways in which patients and providers were asked about the symptoms patients experience. We sought to (1) describe the prevalence of patient-reported symptoms in the post-cART era; (2) identify those patient-reported symptoms which are most strongly associated with health-related quality of life (HRQoL), hospitalization and mortality; and (3) determine whether primary providers recognize symptoms associated with HRQoL, hospitalization and mortality. We conducted a secondary analysis using baseline survey data from the Veterans Aging Cohort Study and determined which patient-reported symptoms correlated with clinical outcomes using regression analyses. Kappa scores were then calculated. HIV-infected patients suffer from a high burden of symptoms in the post-cART era. Nine out of 20 symptoms correlated with clinical outcomes. Providers universally under recognized symptoms and demonstrated poor agreement beyond chance when patient-report was used as the gold standard.

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Acknowledgements

We would like to gratefully acknowledge Joseph Goulet for sharing his expertise and input in preparing this manuscript. This work was funded by The Veterans Health Administration, Robert Wood Johnson Clinical Scholars Program, Robert Wood Johnson Generalist Faculty Scholars Program, National Institute on Alcohol Abuse and Alcoholism (U10 AA 13566) and VHA Public Health Strategic Health Core Group, and National Institute on Aging.

Conflicts of Interest Statement

No known conflicts of interest to report.

Author information

Authors and Affiliations

  1. Robert Wood Johnson Clinical Scholars Program, New Haven, CT, USA

    E. J. Edelman

  2. Department of Medicine, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA

    E. J. Edelman, K. Gordon & A. C. Justice

  3. Yale University School of Medicine, P.O. Box 208088, New Haven, CT, 06520-8088, USA

    E. J. Edelman

  4. Yale University School of Medicine and Public Health, New Haven, CT, USA

    A. C. Justice

Authors
  1. E. J. Edelman
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  2. K. Gordon
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  3. A. C. Justice
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Correspondence to E. J. Edelman.

Additional information

This work was presented as a poster at the National Meeting of the Society of General Internal Medicine, Minneapolis, MN on April 30th, 2010.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

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Edelman, E.J., Gordon, K. & Justice, A.C. Patient and Provider-Reported Symptoms in the Post-cART Era. AIDS Behav 15, 853–861 (2011). https://doi.org/10.1007/s10461-010-9706-z

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