HIV/AIDS Prevention, Diagnosis, and Treatment in Older Patients - PowerPoint PPT Presentation

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HIV/AIDS Prevention, Diagnosis, and Treatment in Older Patients

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... and Treatment in Older Patients. An Interactive Online CME Program for Primary Care Providers. NIA Grant # R44AG019518 ... Long-Term Follow-up (6 months) ... – PowerPoint PPT presentation

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Title: HIV/AIDS Prevention, Diagnosis, and Treatment in Older Patients


1
HIV/AIDS Prevention, Diagnosis, and Treatment in
Older Patients
  • An Interactive Online CME Program for Primary
    Care Providers
  • NIA Grant R44AG019518

Rita Strombeck, Ph.D. HealthCare Education
Associates
2
Study Goals
  • to develop a cost-effective Internet-based
    education program that will improve the
    performance of physicians and other health
    professionals in preventing, diagnosing, and
    managing HIV/AIDS in persons over age 50.

3
Study Features
  • 2 1/2 years
  • Phase 1 define learning objectives, develop and
    review curriculum, (6 months)
  • Phase 2 refine develop online program format,
    validate curriculum in clinical setting, compare
    online education to traditional written format (2
    years)

4
Need
  • Health care providers less likely to discuss
    HIV/AIDS with older patients (Skiest Kaiser,
    1997).
  • Providers less likely to recognize HIV-associated
    diagnoses and symptoms in older adults (Alpert et
    al. 1996 Justice Y Weissman, 1998).
  • Timely diagnosis of HIV/AIDS in older adults
    frequently delayed (CDC 1996 Vanhems et al.
    1999).
  • Treatment difficulties in older patients due to
    multiple comorbidities, potential drug
    interactions, and altered pharmacokinetics
    (Gegeny 2000).

5
Current CME Programs on HIV/AIDS
  • Linear, text-based presentation
  • Live lectures
  • Online offerings
  • - mostly linear, few interactive
    opportunities

6
Transformation of CME
  • Growth of online CME offerings
  • 13 sites in 1997
  • 135 sites in 2000
  • Increase in number of users of eCME
  • 204,000 physicians in 2000
  • 363,000 physicians in 2003
  • Source Manhattan Research August, 2003

7
What is Needed
  • To be effective, CME models need to incorporate
    interactive CME sessions that enhance participant
    activity and provide the opportunity to practice
    skills .
  • Davis DA, Thomson O'Brien MA, Freemantle N, Wolf
    FM, Mazmanian P, Taylor-Vaisey A. Do conferences,
    workshops, rounds, and other traditional
    continuing education activities change physician
    behavior or health care outcomes? JAMA.
    1999282867-874.
  • -

8
Our Challenge
  • Address practice problems
  • Utilize principles of adult learning when
    designing the program
  • Help physicians realize their own deficiencies
  • Match the desired learning objective with an
    appropriate education format

9
Address Practice Problems
  • Link specific educational interventions to
    specific practice problems
  • Problem
  • - not enough time to screen all patients
    for HIV
  • Possible Solutions
  • - Patient self-assessment questionnaire
  • - Staff Training Guide - Train staff members
    to conduct screening and counseling

10
Utilize Adult Learning Principles
  • Self-directed learning events
  • Use of multiple stimuli
  • Relevant/practical information
  • Problem-based experiences
  • Transference of learning to real life

11
Help Physicians Realize Deficiencies
  • Needs assessment
  • Compare responses to peers (online
    CME has unique advantage)

12
Match Learning Objective to Appropriate
Educational Format
  • Objectives To increase
  • 1. awareness of the epidemiology of HIV/AIDS
    in adults over age 50
  • 2. ability to conduct an age-sensitive risk
    assessment
  • 3. ability to discuss risk reduction
    strategies with at-risk midlife and older
    patients
  • 4. knowledge/recognition of the clinical
    manifestations of HIV in older adults
  • 5. ability to conduct age-sensitive pre- and
    post-test counseling
  • 6. ability to provide age-appropriate care

13
Program Overview
  • Needs Assessment
  • Virtual Patient Encounters (8-10)
  • - screening/counseling (2-4)
  • - testing (2-4)
  • - pre- and post-test counseling (2-4)
  • - care management (6)
  • Conference Room
  • - audio/visual lectures on select topics
  • Library
  • - written articles on various topics that can be
    printed
  • File Cabinet
  • assessment tools, patient handouts, etc.
  • Activities
  • - Q A, mini-cases, etc.
  • Internet Resources

14
Waiting Room
15
62-year old retired chiropractor Bill
Watson complains of fatigue,
sleeplessness, weight
loss
16
Conference Room
17
Conference Room
  • SCREENING FOR HIV/AIDS
  • HOW TO CONDUCT A ONE-ON-ONE RISK ASSESSMENT
  • SYMPTOMS OF HIV/AIDS IN OLDER ADULTS
  • THE INCIDENCE OF HIV/AIDS IN LATER LIFE
  • HIV/AIDS RISK FACTORS FOR OLDER ADULTS
  • POST-TEST COUNSELING/EVALUATION
  • PSYCHOSOCIAL NEEDS
  • END-OF-LIFE CONSIDERATIONS
  • WELLNESS COUNSELING
  • HEPATITIS C
  • MANAGEMENT OF HIV
  • THE AGING IMMUNE SYSTEM
  • TREATING OLDER ADULTS
  • STRATEGIES FOR INCREASING ADHERENCE TO
    ANTIRETROVIRAL THERAPY
  • DEALING WITH PSYCHIATRIC ISSUES

18
Library
19
Library/Articles
  • DIAGNOSTIC ISSUES
  • HIV DISEASE PROGRESSION IN OLDER ADULTS BEFORE
    HAART
  • HIV DISEASE IN OLDER ADULTS RESPONSE TO HAART
  • GUIDELINES FOR THE TREATMENT OF HIV-INFECTED
    ADULTS
  • ADVERSE EVENTS ASSOCIATED WITH ANTIRETROVIRAL
    THERAPY IN OLDER PATIENTS
  • DRUG INTERACTIONS
  • PRESENCE OF COMORBIDITIES IN OLDER HIV-INFECTED
    ADULTS
  • PSYCHIATRIC DISORDERS
  • HIV-ASSOCIATED DEMENTIA AND OLDER PATIENTS
  • COMPLEMENTARY AND ALTERNATIVE THERAPY

20
Virtual Clinic/map
21
Evaluation
  • Immediate Effects
  • Comparison to a Traditional CME Group
  • Satisfaction
  • Long-Term Follow-up (6 months)
  • The degree to which information provided in CME
    program is incorporated into practice

22
More Information
  • HealthCare Education Associates
  • www.hceassoc.com
  • RStromb_at_cs.com

23
Program Available in Fall 2004
  • The Virtual Lecture Hall
  • www.vlh.com
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