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Development and application of a new measure of engagement in out‐patient HIV care
OBJECTIVES: Commonly used measures of engagement in HIV care do not take into account that the frequency of attendance is related to changes in treatment and health status. This study developed a new measure of engagement in care (EIC) incorporating clinical factors. METHODS: We conducted semi‐struc...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347876/ https://www.ncbi.nlm.nih.gov/pubmed/27535219 http://dx.doi.org/10.1111/hiv.12427 |
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author | Howarth, AR Burns, FM Apea, V Jose, S Hill, T Delpech, VC Evans, A Mercer, CH Michie, S Morris, S Sachikonye, M Sabin, C Ainsworth, Jonathan Allan, Sris Anderson, Jane Babiker, Abdel Chadwick, David Dunn, David Fisher, Martin Gazzard, Brian Gilson, Richard Gompels, Mark Hay, Phillip Johnson, Margaret Kegg, Stephen Leen, Clifford Martin, Fabiola Nelson, Mark Orkin, Chloe Palfreeman, Adrian Phillips, Andrew Pillay, Deenan Post, Frank Pritchard, Jillian Schwenk, Achim Tariq, Anjum Trevelion, Roy Walsh, John Thornton, Alicia Huntington, Susie Glabay, Adam Perry, N. Tilbury, S. Youssef, E. Churchill, D. Everett, R. Asboe, D. Mandalia, S. Korat, H. Taylor, C. Gleisner, Z. Ibrahim, F. Campbell, L. Brima, N. Williams, I. Youle, M. Lampe, F. Smith, C. Tsintas, R. Chaloner, C. Hutchinson, S. Mackie, N. Winston, A. Weber, J. Ramzan, F. Carder, M. Lynch, J. Hand, J. Souza, C. Anderson, J. Munshi, S. Miller, S. Wood, C. Leen, C. Wilson, A. Morris, S. Memon, K. Lewszuk, A. Cope, E. Gibson, J. Main, P. Mitchell, S. Hunter, M. Dhillon, M. Russell‐Sharpe, S. Harte, A. Clay, S. Tariq, A. Spencer, H. Jones, R. Cumming, S. Atkinson, C. |
author_facet | Howarth, AR Burns, FM Apea, V Jose, S Hill, T Delpech, VC Evans, A Mercer, CH Michie, S Morris, S Sachikonye, M Sabin, C Ainsworth, Jonathan Allan, Sris Anderson, Jane Babiker, Abdel Chadwick, David Dunn, David Fisher, Martin Gazzard, Brian Gilson, Richard Gompels, Mark Hay, Phillip Johnson, Margaret Kegg, Stephen Leen, Clifford Martin, Fabiola Nelson, Mark Orkin, Chloe Palfreeman, Adrian Phillips, Andrew Pillay, Deenan Post, Frank Pritchard, Jillian Schwenk, Achim Tariq, Anjum Trevelion, Roy Walsh, John Thornton, Alicia Huntington, Susie Glabay, Adam Perry, N. Tilbury, S. Youssef, E. Churchill, D. Everett, R. Asboe, D. Mandalia, S. Korat, H. Taylor, C. Gleisner, Z. Ibrahim, F. Campbell, L. Brima, N. Williams, I. Youle, M. Lampe, F. Smith, C. Tsintas, R. Chaloner, C. Hutchinson, S. Mackie, N. Winston, A. Weber, J. Ramzan, F. Carder, M. Lynch, J. Hand, J. Souza, C. Anderson, J. Munshi, S. Miller, S. Wood, C. Leen, C. Wilson, A. Morris, S. Memon, K. Lewszuk, A. Cope, E. Gibson, J. Main, P. Mitchell, S. Hunter, M. Dhillon, M. Russell‐Sharpe, S. Harte, A. Clay, S. Tariq, A. Spencer, H. Jones, R. Cumming, S. Atkinson, C. |
author_sort | Howarth, AR |
collection | PubMed |
description | OBJECTIVES: Commonly used measures of engagement in HIV care do not take into account that the frequency of attendance is related to changes in treatment and health status. This study developed a new measure of engagement in care (EIC) incorporating clinical factors. METHODS: We conducted semi‐structured interviews with eight HIV physicians to identify factors associated with the timing of patients' next scheduled appointments. These factors informed the development of an algorithm to classify each month of follow‐up as “in care” (on or before the time of the next expected attendance) or “out of care” (after the time of the next expected attendance). The EIC algorithm was applied to data from the UK Collaborative HIV Cohort (UK CHIC) study, a large clinical cohort study. RESULTS: The interviews indicated that time to next appointment varied depending on psychosocial and physical comorbidities, and clinical factors (time since diagnosis, AIDS diagnosis, treatment status, CD4 count and viral load). The resulting EIC algorithm was applied to 44 432 patients; 83.9% of the 3 021 224 person‐months were “in care”. Greater EIC was independently associated with older age, white ethnicity, HIV acquisition through sex between men, current use of antiretroviral therapy (ART), a higher nadir CD4 count, later calendar year and being seen at the clinic for the first time within the last year. CONCLUSIONS: This algorithm describing engagement in HIV care incorporates a time‐updated measure of patients' treatment and health status. It adds to the options available for measuring this key performance indicator. |
format | Online Article Text |
id | pubmed-5347876 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-53478762017-03-23 Development and application of a new measure of engagement in out‐patient HIV care Howarth, AR Burns, FM Apea, V Jose, S Hill, T Delpech, VC Evans, A Mercer, CH Michie, S Morris, S Sachikonye, M Sabin, C Ainsworth, Jonathan Allan, Sris Anderson, Jane Babiker, Abdel Chadwick, David Dunn, David Fisher, Martin Gazzard, Brian Gilson, Richard Gompels, Mark Hay, Phillip Johnson, Margaret Kegg, Stephen Leen, Clifford Martin, Fabiola Nelson, Mark Orkin, Chloe Palfreeman, Adrian Phillips, Andrew Pillay, Deenan Post, Frank Pritchard, Jillian Schwenk, Achim Tariq, Anjum Trevelion, Roy Walsh, John Thornton, Alicia Huntington, Susie Glabay, Adam Perry, N. Tilbury, S. Youssef, E. Churchill, D. Everett, R. Asboe, D. Mandalia, S. Korat, H. Taylor, C. Gleisner, Z. Ibrahim, F. Campbell, L. Brima, N. Williams, I. Youle, M. Lampe, F. Smith, C. Tsintas, R. Chaloner, C. Hutchinson, S. Mackie, N. Winston, A. Weber, J. Ramzan, F. Carder, M. Lynch, J. Hand, J. Souza, C. Anderson, J. Munshi, S. Miller, S. Wood, C. Leen, C. Wilson, A. Morris, S. Memon, K. Lewszuk, A. Cope, E. Gibson, J. Main, P. Mitchell, S. Hunter, M. Dhillon, M. Russell‐Sharpe, S. Harte, A. Clay, S. Tariq, A. Spencer, H. Jones, R. Cumming, S. Atkinson, C. HIV Med Original Research OBJECTIVES: Commonly used measures of engagement in HIV care do not take into account that the frequency of attendance is related to changes in treatment and health status. This study developed a new measure of engagement in care (EIC) incorporating clinical factors. METHODS: We conducted semi‐structured interviews with eight HIV physicians to identify factors associated with the timing of patients' next scheduled appointments. These factors informed the development of an algorithm to classify each month of follow‐up as “in care” (on or before the time of the next expected attendance) or “out of care” (after the time of the next expected attendance). The EIC algorithm was applied to data from the UK Collaborative HIV Cohort (UK CHIC) study, a large clinical cohort study. RESULTS: The interviews indicated that time to next appointment varied depending on psychosocial and physical comorbidities, and clinical factors (time since diagnosis, AIDS diagnosis, treatment status, CD4 count and viral load). The resulting EIC algorithm was applied to 44 432 patients; 83.9% of the 3 021 224 person‐months were “in care”. Greater EIC was independently associated with older age, white ethnicity, HIV acquisition through sex between men, current use of antiretroviral therapy (ART), a higher nadir CD4 count, later calendar year and being seen at the clinic for the first time within the last year. CONCLUSIONS: This algorithm describing engagement in HIV care incorporates a time‐updated measure of patients' treatment and health status. It adds to the options available for measuring this key performance indicator. John Wiley and Sons Inc. 2016-08-18 2017-04 /pmc/articles/PMC5347876/ /pubmed/27535219 http://dx.doi.org/10.1111/hiv.12427 Text en © 2016 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Research Howarth, AR Burns, FM Apea, V Jose, S Hill, T Delpech, VC Evans, A Mercer, CH Michie, S Morris, S Sachikonye, M Sabin, C Ainsworth, Jonathan Allan, Sris Anderson, Jane Babiker, Abdel Chadwick, David Dunn, David Fisher, Martin Gazzard, Brian Gilson, Richard Gompels, Mark Hay, Phillip Johnson, Margaret Kegg, Stephen Leen, Clifford Martin, Fabiola Nelson, Mark Orkin, Chloe Palfreeman, Adrian Phillips, Andrew Pillay, Deenan Post, Frank Pritchard, Jillian Schwenk, Achim Tariq, Anjum Trevelion, Roy Walsh, John Thornton, Alicia Huntington, Susie Glabay, Adam Perry, N. Tilbury, S. Youssef, E. Churchill, D. Everett, R. Asboe, D. Mandalia, S. Korat, H. Taylor, C. Gleisner, Z. Ibrahim, F. Campbell, L. Brima, N. Williams, I. Youle, M. Lampe, F. Smith, C. Tsintas, R. Chaloner, C. Hutchinson, S. Mackie, N. Winston, A. Weber, J. Ramzan, F. Carder, M. Lynch, J. Hand, J. Souza, C. Anderson, J. Munshi, S. Miller, S. Wood, C. Leen, C. Wilson, A. Morris, S. Memon, K. Lewszuk, A. Cope, E. Gibson, J. Main, P. Mitchell, S. Hunter, M. Dhillon, M. Russell‐Sharpe, S. Harte, A. Clay, S. Tariq, A. Spencer, H. Jones, R. Cumming, S. Atkinson, C. Development and application of a new measure of engagement in out‐patient HIV care |
title | Development and application of a new measure of engagement in out‐patient HIV care |
title_full | Development and application of a new measure of engagement in out‐patient HIV care |
title_fullStr | Development and application of a new measure of engagement in out‐patient HIV care |
title_full_unstemmed | Development and application of a new measure of engagement in out‐patient HIV care |
title_short | Development and application of a new measure of engagement in out‐patient HIV care |
title_sort | development and application of a new measure of engagement in out‐patient hiv care |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347876/ https://www.ncbi.nlm.nih.gov/pubmed/27535219 http://dx.doi.org/10.1111/hiv.12427 |
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