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, King K. Holmes

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)803-811
Number of pages9
JournalClinical Infectious Diseases
Volume36
Issue number6
DOIs
StatePublished - Mar 15 2003
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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