Document Detail


Electronic human immunodeficiency virus (HIV) clinical reminder system improves adherence to practice guidelines among the University of Washington HIV Study Cohort.
MedLine Citation:
PMID:  12627367     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We conducted a prospective study of an electronic clinical reminder system in an academic medical center-based human immunodeficiency virus (HIV) specialty clinic. Published performance indicators were used to examine adherence to HIV practice guidelines before and after its implementation for 1204 patients. More than 90% of patients received CD4 cell count and HIV type 1 (HIV-1) RNA level monitoring every 3-6 months during both time periods, and approximately 80% of patients with a CD4 cell count nadir of <350 cells/mm(3) received highly active antiretroviral therapy. Patients were significantly more likely to receive prophylaxis against Mycobacterium avium complex (hazard ratio, 3.84; 95% confidence interval [CI], 1.58-9.31; P=.003), to undergo annual cervical carcinoma screening (OR, 2.09; 95% CI, 1.04-4.16; P=.04), and to undergo serological screening for Toxoplasma gondii (odds ratio [OR], 1.86; 95% CI, 1.05-3.27; P=.03) and syphilis infection (OR, 3.71; 95% CI, 2.37-5.81; P<.0001). HIV clinical reminders delivered at the time that HIV care is provided were associated with more timely initiation of recommended practices.
Authors:
Mari M Kitahata; Peter W Dillingham; Nathorn Chaiyakunapruk; Susan E Buskin; Jeffrey L Jones; Robert D Harrington; Thomas M Hooton; King K Holmes;
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.     Date:  2003-03-04
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  36     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-10     Completed Date:  2003-03-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  803-11     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Washington, Harborview Medical Center, Box 359931, 325 9th Ave., Seattle, WA 98104, USA. kitahata@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Anti-HIV Agents / therapeutic use
Antibiotic Prophylaxis
CD4 Lymphocyte Count
Cohort Studies
Guideline Adherence*
HIV Infections / drug therapy,  immunology
HIV-1 / physiology
Humans
Mass Screening
Opportunistic Infections / prevention & control
Practice Guidelines as Topic
Prospective Studies
RNA, Viral / metabolism
Reminder Systems*
Time Factors
Grant Support
ID/Acronym/Agency:
AI-01789/AI/NIAID NIH HHS; AI-27757/AI/NIAID NIH HHS; CDC-D22967D/DC/NIDCD NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/RNA, Viral

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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