Physicians' recognition of the symptoms experienced by HIV patients: How reliable?

To assess how well physicians recognize common symptoms in HIV patients and identify factors associated with symptom recognition, a multicenter cross- sectional survey was performed in a random sample of 118 hospitalized and 1 72 ambulatory HIV patients, and their attending physicians. Patients' repor ts of 16 different symptoms were compared to physicians' reports of whether each symptom was present and/or specific treatments prescribed. Overall, f atigue anxiety, skin problems, fever; and weight loss were more often recog nized fry physicians than other symptoms. Agreement between patients and ph ysicians was poor to moderate, with Kappa statistics ranging from 0.17 (dry mouth) to 0.58 (fever). Recognition was independently more likely for ambu latory patients (adjusted odds ratio 1.69, P < 0.001) and for patients seen as sicker (adjusted odds ratio 1.88 P < 0.001). Appropriate symptom management requires improved symptom recognition. More systematic clinical examinations, including attentive patient interview are needed. J. Pain Symptom Manage 1999;18:263-270. (C) U.S. Cancer Pain Relie f Committee, 1999.