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

Kitahata, Mari M.; Dillingham, Peter W.; Chaiyakunapruk, Nathorn; Buskin, Susan E.; Jones, Jeffrey L.; Harrington, Robert D.; Hooton, Thomas M.; Holmes, King K.
March 2003
Clinical Infectious Diseases;3/15/2003, Vol. 36 Issue 6, p803
Academic Journal
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/mm[SUP3] 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.


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