Journal Article

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

Mari M. Kitahata, Peter W. Dillingham, Nathorn Chaiyakunapruk, Susan E. Buskin, Jeffrey L. Jones, Robert D. Harrington, Thomas M. Hooton and King K. Holmes

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 36, issue 6, pages 803-811
Published in print March 2003 | ISSN: 1058-4838
Published online March 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/368085
Electronic Human Immunodeficiency Virus (HIV) Clinical Reminder System Improves Adherence to Practice Guidelines among the University of Washington HIV Study Cohort

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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.

Journal Article.  4743 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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