Abstract #134  -  Development of an educational package for clear and comprehensive physician-patient communication about complex multidimensional topics regarding HIV infection, HAART, and adherence-resistance relationship: the SUPPORT-HIV Study.
Authors:   Presenting Author:   Dr Adriana Ammassari - National Institute for Infectious Diseases
Additional Authors:  MD Adriana Ammassari, MD Mario Paola Trotta, Mr Daniele Malantrucco, Psy Paola Pierro, Mrs Rosaria Iardino, MD Andrea Antinori,
Aim: Issues: Clinical management of HIV infection is peculiar in respect to other chronic diseases, because of modest disease knowledge among patients, impossibility of symptom-guided drug intake, and tremendous complexity of treatment-adherence-resistance relationship. The understanding of these complex, interdependent facts based on verbal communication is among non-professionals frequently partial, unclear and insufficient to allow them to engage in efficient health behavior. Aim of the project was to develop an educational package that helps HIV-positive persons to understand their illness and the importance of taking their medications.
Method / Issue: Project: The educational package was conceived by HIV-specialists and HIV-infected patients, who eagerly met on several occasions to identify the most relevant topics to convey essential information for improvement/maintenance of HAART adherence. The study team agreed on the usefulness of designing for each topic two illustrations: one with the scientific information and another with the emotional dimension. Illustrations and wordings should avoid gender-, cultural-, and religious-bias.
Results / Comments: Results: For the educational package a set of 10 double-face illustrated cards was developed and structured as follows: three cards address general information on HIV infection; three cards focus on HAART; three cards deal with adherence-resistance relationship. The last card summarizes “10 good tips” for HAART adherence. Each card opens with a prompt and direct question, that synthesizes possible worries of the patient. Answers to the questions emerge essentially through graphical illustrations, which give straight visual information. On the rear of each card a picture tries to show the inner feelings which might accompany the question on the card.
Discussion: Lessons learned: Effective physician-patient communication is key element to enhance health motivation and improve self-efficacy among HIV-infected persons. Patient empowerment is essential for best possible disease management of chronic disorders. Specific patient populations, such as recently HIV-diagnosed, HAART non-adherent, illiterates, and immigrants, might benefit more clearly from this educational intervention.
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