Electronic Human Immunodeficiency Virus (HIV) Clinical Reminder System Improves Adherence to Practice Guidelines among the University of Washington HIV Study Cohort

Author(s)
Kitahata, Mari M
Dillingham, Peter
Chaiyakunapruk, Nathorn
Buskin, Susan E
Jones, Jeffrey L
Harrington, Robert D
Hooton, Thomas M
Holmes, King K
Publication Date
2003
Abstract
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 ~80% of patients with a CD₄ cell count nadir of <350 cells/mm³ 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.
Citation
Clinical Infectious Diseases, 36(6), p. 803-811
ISSN
1537-6591
1058-4838
Link
Publisher
Oxford University Press
Title
Electronic Human Immunodeficiency Virus (HIV) Clinical Reminder System Improves Adherence to Practice Guidelines among the University of Washington HIV Study Cohort
Type of document
Journal Article
Entity Type
Publication

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