755 2015 755 HRSA HAB - ART Survey

HRSA HAB ARV Guidelines Customer Satisfaction Questionnaire

________________________________________________________________________________________________________________

Health Resources and Services Administration

HIV/AIDS Bureau (HRSA – HAB)

Adult and Adolescent Antiretroviral (ARV) Guidelines

Customer Satisfaction Survey

Survey to be administered via the web. Questionnaire section headers, bolded instructions and question numbers will not appear on screen. All rated questions will have ”don’t know/not applicable” options.

E-Mail Invitation

The Panel on Antiretroviral (ARV) Guidelines for Adults and Adolescents through the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB), is conducting a survey to assess access and utilization of the Department of Health and Human Services (HHS) Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents (https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-treatment-guidelines/0). As you complete this survey, please reflect on the interactions and experiences with the guidelines over the past 12 months. The Panel's goal is to use the survey feedback that you provide to help us further refine our commitment and actions to improve the accessibility and utilization of the HHS Guidelines for ARV in Adults and Adolescents within a practice setting.

We would appreciate it if you would take a few minutes to complete the survey via the Internet by clicking on the link below.

[link]

The survey will take approximately 15 minutes to complete. CFI Group, an independent research and consulting firm, is conducting this survey. The survey is hosted via a secure server and your responses will remain anonymous. If you have any questions, please contact [email protected].

This information will be vital for the Panel to improve the guidelines and our future actions. We hope you can take the time to complete the questionnaire. Thank you in advance for your participation!

Sincerely,

Alice Pau

Executive Secretary, HHS Panel on Antiretroviral Guidelines for Adults and Adolescents

and

Laura Cheever, MD, ScM

Associate Administrator, HIV/AIDS Bureau

Survey Introduction

The Panel on Antiretroviral Guidelines for Adults and Adolescents and the Health Resources and Service Administration (HRSA) HIV/AIDS Bureau (HAB) is committed to improving the Department of Health and Human Services (HHS) Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. As part of this effort, we are requesting feedback on your experiences with the Guidelines for Antiretroviral (ARV) in Adults and Adolescents in the past year. The survey is hosted via a secure server and your responses will remain anonymous. This survey is authorized by Office of Management and Budget Control No. 1090-0007 (May 31, 2018).

Thank you in advance for completing the survey. If you experience any technical difficulties while taking the survey, please write [email protected].

Please click on the “Next” button below to begin.

Guidelines for Antiretroviral (ARV) in Adults and Adolescents

Q1. Which guidelines or resources do you use for antiretroviral management of adults and adolescents?

1. World Health Organization Guidelines

2. HIV Association AIDS Clinical Society

3. HHS Guidelines for Antiretroviral (ARV) in Adults and Adolescents

4. IAS-USA

5. NY State Guidelines

6. World Health Organization Guidelines

7. British Guidelines

8. European Union Guidelines

9. Point of care information resource such as Up-to-Date, HIV Insite, Johns Hopkins HIV Guide

10. AIDS Education and Training Center resource

11. Other, please specify

12. N/A

Q2. How often do you access the Guidelines for ARV in Adults and Adolescents?

1. This was my first time accessing the HHS Guidelines for ARV in Adults and Adolescents

2. Weekly

3. Monthly

4. 3-4 times per year

5. Only when updated

6. Never

Q3. What format of the Guidelines for ARV in Adults and Adolescents do you use? Please select all that apply.

1. Paper

2. Website via computer

3. Website via mobile device

4. Downloaded application (PDF)

Q4. Why do you access the Guidelines for ARV in Adults and Adolescents? Please select all that apply.

1. Learning how to generally manage HIV

2. Management of a particular patient

3. Update on newest changes

4. Development/revising of policies and procedures

5. Teaching purposes

6. Other, please specify

Q5. How do you usually find information in the Guidelines for ARV in Adults and Adolescents?

1. Search box in the document

2. Index

3. Directly from internet search engine

4. Other, please specify

Q6. Please rank the top five Guidelines for ARV in Adults and Adolescents Sections you most often use.

1. What's New in the Guidelines?

2. Baseline Evaluation

3. Laboratory Testing

   1. Tests for Initial Assessment and Follow-up

   2. Plasma HIV-1 RNA (Viral Load) and CD4 Count Monitoring

   3. Drug-Resistance Testing

   4. Co-receptor Tropism Assays

   5. HLA-B* 5701 Screening

4. Treatment Goals

5. Initiating ART in Treatment-Naive Patients

6. What to Start

7. What Not to Use

8. Management of the Treatment-Experienced Patient

   1. Virologic Failure

   2. Poor CD4 Recovery

   3. Regimen Switching in the Setting of Virologic Suppression

   4. Therapeutic Drug Monitoring

   5. Discontinuation or Interruption of Antiretroviral Therapy

9. Special Patient Populations

   1. Acute and Recent (Early) HIV Infection

   2. HIV-Infected Adolescents and Young Adults

   3. HIV and Illicit Drug Users

   4. HIV-Infected Women

   5. HIV-2 Infection

   6. HIV and the Older Patient

10. Considerations for Antiretroviral Use in Patients with Coinfections

    1. HIV/HBV

    2. HIV/HCV

    3. HIV/TB

11. Limitations to Treatment Safety and Efficacy

    1. Adherence to ART

    2. Adverse Effects of ARV

    3. Cost Considerations and Antiretroviral Therapy

12. Drug Interactions

    1. Overview

    2. Drugs Not Recommended With ARV Agents

    3. PI Drug Interactions

    4. NNRTI Drug Interactions

    5. NRTI Drug Interactions

    6. INSTI Drug Interactions

    7. CCR5 Antagonist Drug Interactions

    8. Interactions Between PIs and NNRTIs

    9. Interactions Between INSTI & NNRTI or PI

13. Preventing HIV Transmission

14. Conclusion

    1. Drug Name Abbreviations

    2. General Terms

15. Appendix B: Drug Characteristics Tables

Q7. List the top 5 tables you use in the Guidelines for ARV in Adults and Adolescents.

1. Table 1. Outline of the Guidelines Development Process

2. Table 2. Rating Scheme for Recommendations

3. Table 3. Laboratory Monitoring Schedule for Patients Before and After Initiation of Antiretroviral Therapy

4. Table 4. Recommendations on the Indications and Frequency of Viral Load and CD4 Count Monitoring

5. Table 5. Recommendations for Using Drug-Resistance Assays

6. Table 6. Recommended, Alternative, and Other Antiretroviral Regimen Options for Treatment-Naive Patients

7. Table 7. Antiretroviral (ARV) Regimen Considerations as Initial Therapy Based on Specific Clinical Scenarios

8. Table 8. Advantages and Disadvantages of Antiretroviral Components Recommended as Initial Antiretroviral Therapy

9. Table 9. Antiretroviral Components or Regimens Not Recommended as Initial Therapy

10. Table 10. Antiretroviral Regimens or Components That Should Not Be Offered At Any Time

11. Table 11. Identifying, Diagnosing, and Managing Acute and Recent HIV-1 Infection

12. Table 12. Concomitant Use of Selected HIV Drugs and FDA-approved HCV Drugs for Treatment of HCV in HIV-Infected Adults

13. Table 13. Strategies to Improve Adherence to Antiretroviral Therapy and Retention in Care

14. Table 14. Antiretroviral Therapy-Associated Common and/or Severe Adverse Effects

15. Table 15. Antiretroviral Therapy-Associated Adverse Events That Can Be Managed with Substitution of Alternative Antiretroviral Agent

16. Table 16. Monthly Average Wholesale Price of Antiretroviral Drug

17. Table 17. Mechanisms of Antiretroviral-Associated Drug Interactions

18. Table 18. Drugs That Should Not Be Used With Antiretroviral Agents

19. Table 19a. Drug Interactions between Protease Inhibitors and Other Drugs

20. Table 19b. Drug Interactions between Non-Nucleoside Reverse Transcriptase Inhibitors and Other Drugs

21. Table 19c. Drug Interactions between Nucleoside Reverse Transcriptase Inhibitors and Other Drugs (Including Antiretroviral Agents)

22. Table 19d. Drug Interactions between Integrase Inhibitors and Other Drugs

23. Table 19e. Drug Interactions between CCR5 Antagonist (Maraviroc) and Other Drugs (Including Antiretroviral Agents) Table 20a. Interactions between Non-Nucleoside Reverse Transcriptase Inhibitors and Protease Inhibitors

24. Table 20b. Interactions between Integrase Strand Transfer Inhibitors and Non-Nucleoside Reverse Transcriptase Inhibitors or Protease Inhibitors

Q8. When you access the Guidelines for ARV in Adults and Adolescents, how frequently do you access the following: (Grid with frequencies of Always, Often, Sometimes, Rarely, Never)

1. Text

2. Tables

3. Boxed Panel’s Recommendations Placed at the Beginning of Sections

Q9. When you refer medical students/residents, other trainees, or colleagues to learn about HIV care, which Guidelines or resources do you use?

1. World Health Organization Guidelines

1. HIV Association AIDS Clinical Society

2. HHS Adult and Adolescent

1. IAS-USA

2. NY State Guidelines

3. World Health Organization Guidelines

4. British Guidelines

5. European Union Guidelines

6. Point of care information resource such as Up-to-Date, HIV Insite, Johns Hopkins HIV Guide

7. AIDS Education and Training Center resource

8. Other, please specify

9. N/A

Q10. Do you have any comments on how you utilize the Guidelines for ARV in Adults and Adolescents? (Capture open end)

Content of Guidelines

Q11. Thinking about the content of the Guidelines for ARV in Adults and Adolescents, rate each of the following using a 10 point scale where “1” means “poor” and “10” means “excellent”

1. Recommendations are clear

2. Recommendations in the HHS guidelines provide credible information based on evidence

3. Recommendations are unbiased

4. Recommendations help me understand issues

5. Recommendations are comprehensive

6. Recommendations provide up-to-date information

7. Recommendations help me manage patients

Q12. If you have recommendations for new topics to be covered in these guidelines, please use this space for your recommendations. (Capture open end)

Q13. If you have recommendations on sections that should be removed, please use this space for your recommendations (Capture open end)

Q14. Please use this space to provide any additional comments about the content of the Guidelines for ARV in Adults and Adolescents. (Capture open end)

Accessibility of Guidelines

Q15. Now, thinking about how you initially go about accessing the Guidelines for ARV in Adults and Adolescents, rate each of the following using a 10 point scale where “1” means “poor” and “10” means “excellent”

1. The guidelines are readily accessible to me

2. The section titles enable me to quickly identify what I need

3. If I am unable to access what I need, it is clear who I contact for assistance

(ASK IF Q3=B:D)

Q16. Now, thinking about how you initially go about accessing the Guidelines for ARV in Adults and Adolescents via the website or downloaded application, rate each of the following using a 10 point scale where “1” means “poor” and “10” means “excellent”

1. The layout helps me find what I am looking for

2. I can rapidly move to the information I need (number of clicks, etc.)

3. Ability to load pages without getting an error message

4. How quickly the pages load

5. Reliability of log in process

Q17. Do you have a need for a mobile or web-based tool to assist in utilizing the Guidelines for ARV in Adults and Adolescents in patient care?

1. Yes

2. No

Usability of Guidelines

Q18. Thinking about how you use the Guidelines for ARV in Adults and Adolescents once you have accessed them, rate each of the following using a 10 point scale where “1” means “poor” and “10” means “excellent”

1. The section titles enable me to quickly identify what I need

2. The ease of finding the information I need

3. The length of the guidelines relative to my needs (i.e. are they too long?)

Q19. In your opinion, what would make the Guidelines for ARV in Adults and Adolescents easier to use? (Capture open end)

Q20. Please use this space to provide any additional comments about the usability of the Guidelines for ARV in Adults and Adolescents. (Capture open end)

Decision Support

Q21. How do you keep up with HIV treatment?

1. Reading guidelines

2. Training/CME on guidelines and/or HIV care

3. Other source of information on HIV care

4. Don’t keep up with HIV treatment recommendations

5. Other, please specify

Q22. How did you hear about this survey?

1. A list of different organizations that disseminated will be provided

2. Other, please specify

ACSI BENCHMARK QUESTIONS

Now, please think about your overall experience with the guidelines

Q23. On a scale of 1 to 10, where 1 means Very Dissatisfied and 10 means Very Satisfied, please rate your overall satisfaction with the Guidelines for ARV in Adults and Adolescents.

Q24. On a scale of 1 to 10 where 1 now means Falls Short of your Expectations and 10 means Exceeds you Expectations, how well do the current Guidelines for ARV in Adults and Adolescents meet your expectations?

Q25. On a scale of 1 to 10, where 1 is Not Very Close to Ideal and 10 is Very Close to Ideal, how close are the Guidelines for ARV in Adults and Adolescents to “ideal”?

Future Actions

On a scale from 1 to 10 where 1 means Not at all Likely and 10 means Very Likely, please rate your likelihood to:

Q26. Continue to use the Guidelines for ARV in Adults and Adolescents

Q27. Recommend the Guidelines for ARV in Adults and Adolescents to others/colleagues

Respondent Demographics

To begin, we would like to ask you some questions about you and your role.

Q28. Which best describes your age?

1. Under 25

2. 25-35

3. 36-45

4. 46-55

5. Over 55

6. Prefer not to answer

Q29. Please indicate your gender.

1. Male

2. Female

3. Prefer not to answer

Q30. How would you categorize your degree(s) or license(s)? Please select all that apply.

1. MD

2. DO MBChB

3. MBBS

4. PhD

5. DSC

6. PharmD

7. MSC

8. NP

9. FNP

10. PA

11. PA-C

12. RN

13. LSW

14. MPH

15. No degree or license

16. Still in training

17. Other, please specify

(IF Q30=a:n, ASK Q31)

Q31. When did you complete your training?

1. Completed training less than 1 year ago

1. Completed training 1 year to less than 5 years

2. Completed training 5 years to less than 10 years

3. Completed training 10 years or more

(IF Q30=p, ASK Q32)

Q32. What is the status of your training?

1. My training will be complete within 1-5 months

2. My training will be complete within 6 to 12 months

3. I have one year or more before my training is complete

Q33. How would you categorize your specialty? Please select all that apply.

1. Family Medicine

2. General Medicine

3. Infectious Disease

4. Internal Medicine

5. Pediatrics/Adolescents

6. Primary Care

7. HIV Medicine

8. OB-GYN

9. I am still in training for my specialty

10. Other, please specify

(IF Q33=i, ASK Q34)

Q34. How would you categorize the specialty for which you are receiving training? Please select all that apply.

1. Family Medicine

2. General Medicine

3. Infectious Disease

4. Internal Medicine

5. Pediatrics/Adolescents

6. Primary Care

7. HIV Medicine

8. OB-GYN

9. Other, please specify

Q35. How would you categorize the primary institution/organization where you work?

1. Academic Institution

2. State or Local Government (including health department)

3. Community-Based organization

4. Employed Physician Practice

5. Health Care Corporation

6. Physician Run Group

7. Pharmaceutical Industry

8. Clinical Research

9. Private Practice (group or solo)

10. Federal Government

36. Please describe your clinical practice setting.

1. Academic Medical Center

2. Clinical Research

3. Hospital-Based Clinic

4. Community-Based Clinic, including federally qualified health center

5. Private practice (group or solo)

6. In-Patient

7. State or County Health Department

8. Veterans Affairs Clinic

9. I do not provide care to people with HIV infection

10. Other, please specify

11. Other, please specify

Q37. Please indicate the state/country where you work. (Drop down menu)

Q38. How many years have you worked in the HIV field?

4. Less than 1 year

5. 1 year to less than 5 years

6. 5 years to less than 10 years

7. 10 years or more

Q39. Do you consider yourself an HIV specialist?

1. Yes

2. No

Q40. Do you provide on-going care for adolescent/adult patients with HIV infection?

1. Yes

2. No

(IF Q40 = a, ASK Q41)

Q41. What is your role in management for adolescent/adults of persons with HIV infection? Please select all that apply.

1. Prescribe ARV therapy for people with HIV infection in the outpatient setting

2. Part of care team but don’t actually prescribe ARV therapy

3. Patient education only

4. Case management

5. Other, please specify

6. Provide inpatient care for people with HIV infection

(IF Q40 = a, ASK Q42)

Q42. What is the size of your HIV-infected outpatient panel?

1. 1-20

2. 21-50

3. 51-100

4. 101-200

5. More than 200

11. Other, please specify

6. I do not have an outpatient population.

Conclusion

Q42. Please use the space provided to offer any final comments or recommendations about the Guidelines for ARV in Adults and Adolescents. (Capture open end)