Tools to help providers and patients communicate about HIV and increase therapeutic adherence are provided in this section.

Process and system tools are provided to assist in making practice improvements.






Behavioral Screening
A screening tool to identify patient behavioral issues in the areas of mental health, alcohol use, drug use, smoking, medication adherence, and condom use.
Duke ID Clinic Behavioral Health Screener

DHHS Guidelines
The Department of Health and Human Services released updated guidelines, which address CD-4 count, viral load, and drug resistance testing. Table 3, Laboratory Monitoring Schedule for Patients Prior to and After Initiation of Antiretroviral Therapy, summarizes recommended monitoring practices at different stages of disease management.

Heart Attack Risk Assessment
Based on data from the Framingham heart study, this tool can help assess the risk of having a heart attack or dying from coronary heart disease.

Kidney Function Assessment
Enter plasma creatinine, weight, gender, and age and this Cockcroft-Gault Calculator will produce the creatinine clearance rate.



DHHS Guidelines
The Department of Health and Human Services released updated guidelines in January 2011, which address criteria for initiation of therapy, combination regimens, managing special populations, drug interactions, and more.

Assess Patient Readiness for Adherence
Use this questionnaire to assess patients for readiness to adhere to a therapeutic regimen. Domains include mental health, substance use, environment, cognitive state, and attitude.
Readiness Awareness Assessment Tool

Managing Coinfection
Links to news articles and conference coverage on HIV/AIDS, HepB, HepC, and coinfection.

STD Treatment Guidelines
CDC guidelines on management of sexually transmitted diseases was updated in December 2010. Both online and pdf versions are available.

Opportunistic Infections
CDC MMWR Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents. This document provides optimal strategies for prevention and management of OIs in patients with HIV.

HIV Drug Resistance Database
Stanford University hosts a curated public database designed to represent, store, and analyze the divergent forms of data underlying HIV drug resistance. The tool allows viewing of mutation scores and comments after reverse transcriptase, protease, or integrase mutation data is entered through text or pull-down lists.
Main page:

Drug Resistance Mutations
This December 2010 update of the International AIDS Society–USA (IAS–USA) drug resistance mutations lists mutations in the genes targeted by ART.

Current Articles and News
Links to current articles and news updates are provided in the areas of HIV, hepatitis B and C, bone disease, liver transplantation, conferences, and more.

Current News, Opinion, Policy Analysis
Comprehensive, up-to-date information on HIV/AIDS treatment, prevention, and policy. Site is a project of UCSF.



Adherence Assessment Script
This is a scripted interview format that gives tools to explore patient barriers to adherence. Positive behavior is reinforced and the provider can probe the patient's interest, confidence, and values.

Self-Management Support
The Robert Wood Johnson Foundation developed the Assessment of Primary Care Resources and Supports for Chronic Disease Self-Management (PCRS) tool to assess both organizational infrastructure and delivery of self management support services.

Medication Tracker
A tool for patients to organize and track their test results and medications. Includes toll-free national HIV/AIDS treatment hotline 1-800-822-7422.

The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring, and measuring the severity of depression.

Multilingual Fact Sheets
This New Mexico project provides non-technical printable handout sheets with explanations of multiple aspects of HIV care. Originally only in Spanish and English, the offerings have expanded to help patients of different ethnic origins.

Patient Education
Related sites to aid patient/provider communication. The patient version covers basic information, hot topics, news, patient profiles, discussion threads, and more. The professional site contains clinical results, conference coverage, prevention, epidemiology, etc.



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