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

Details

• Alternative Title:
  Int J Infect Dis
• Personal Author:
  Oluoch, Tom ; Kwaro, Daniel ; Ssempijja, Victor ; Katana, Abraham ; Langat, Patrick ; Okeyo, Nicky ; Abu-Hanna, Ameen ; de Keizer, Nicolette
• Description:
  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 18 523 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.
  
  
• Subjects:
  Adult Anti-Retroviral Agents Electronic Health Records Female Guideline Adherence HIV Infections Humans Kenya Male Patient Compliance Retrospective Studies Young Adult

  More +
• Keywords:
  Developing Countries EHealth Electronic Medical Records Guideline Adherence HIV Quality Of Care
• Source:
  Int J Infect Dis. 33:109-113
• Pubmed ID:
  25281905
• Pubmed Central ID:
  PMC4987124
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/ ; U01 GH000048/GH/CGH CDC HHSUnited States/ ; GH000048-04/GH/CGH CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/
• Volume:
  33
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:fc251577d2010a79007a049cf46fa7c9682d8cf30a0fc8831a8d3bcce71cf29f
• Download URL:
  https://stacks.cdc.gov/view/cdc/40904/cdc_40904_DS1.pdf
• File Type:
  [PDF - 360.59 KB ]