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Comparative Study
. 2015 Apr:33:109-13.
doi: 10.1016/j.ijid.2014.06.004. Epub 2014 Oct 2.

Better adherence to pre-antiretroviral therapy guidelines after implementing an electronic medical record system in rural Kenyan HIV clinics: a multicenter pre-post study

Tom Oluoch  1 , Daniel Kwaro  2 , Victor Ssempijja  3 , Abraham Katana  3 , Patrick Langat  2 , Nicky Okeyo  2 , Ameen Abu-Hanna  4 , Nicolette de Keizer  4
Affiliations
Comparative Study

Better adherence to pre-antiretroviral therapy guidelines after implementing an electronic medical record system in rural Kenyan HIV clinics: a multicenter pre-post study

Tom Oluoch et al. Int J Infect Dis. 2015 Apr.

Abstract

Introduction: The monitoring of pre-antiretroviral therapy (pre-ART) is a key indicator of HIV quality of care. This study investigated the association of an electronic medical record system (EMR) with adherence to pre-ART guidelines in rural HIV clinics in Kenya.

Methods: A retrospective study was carried out to assess the quality of pre-ART care using three indicators: (1) the performance of a baseline CD4 test, (2) time from enrollment in care to first CD4 test, and (3) time from baseline CD4 to second CD4 test. A comparison of these indicators was made pre and post the introduction of an EMR system in 17 rural HIV clinics.

Results: A total of 18523 patients were receiving pre-ART care, of whom 38.8% in the paper group had had at least one CD4 test compared to 53.4% in the EMR group (p<0.001). The adjusted odds of performing a CD4 test in clinics using an EMR was 1.59 (95% confidence interval 1.49-1.69). The median time from enrolment into HIV care to first CD4 test was 1.40 months (interquartile range (IQR) 0.47-4.87) for paper vs. 0.93 months (IQR 0.43-3.37) for EMR. The median time from baseline to first CD4 follow-up was 7.5 months (IQR 5.97-10.73) for paper and 6.53 months (IQR 5.57-7.87) for EMR.

Conclusion: The use of the EMR system was associated with better compliance to HIV guidelines for pre-ART care. EMRs have a potential positive impact on quality of care for HIV patients in resource-constrained settings.

Keywords: Developing countries; Electronic medical records; Guideline adherence; HIV; Quality of care; eHealth.

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Conflict of interest statement

Conflict of interest: None.

Figures

Figure 1
Figure 1
Time from enrolment into HIV care to first CD4 test among pre-ART patients.
Figure 2
Figure 2
Time from first to second CD4 test among pre-ART HIV care patients.
See this image and copyright information in PMC

References

    1. World Health Organization. Towards universal access: scaling up priority HIV/AIDS interventions in the health sector: progress report 2010. Geneva: WHO; 2010.
    1. Global report: UNAIDS report on the global AIDS epidemic 2012. UNAIDS; 2013.
    1. Lawn SD, Wood R. CD4 cell count distributions and HIV-associated mortality in Africa. J Infect Dis. 2007;195:1078–9. - PubMed
    1. Oliveira I, Andersen A, Furtado A, Medina C, da Silva D, da Silva ZJ, et al. Assessment of simple risk markers for early mortality among HIV-infected patients in Guinea-Bissau: a cohort study. BMJ Open. 2012;2(6):e001587. - PMC - PubMed
    1. Hoffmann CJ, Lewis JJ, Dowdy DW, Fielding KL, Grant AD, Martinson NA, et al. Mortality associated with delays between clinic entry and ART initiation in resource-limited settings: results of a transition-state model. J Acquir Immune Defic Syndr. 2013;63:105–11. - PMC - PubMed

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