Effects of a Laboratory Health Information Exchange Intervention on Antiretroviral Therapy Use, Viral Suppression, and Racial/Ethnic Disparities
| Autor: | Terry T. Nakazono, Danielle S. Seiden, Janni J. Kinsler, Douglas S. Bell, Laral Andrews, William E. Cunningham, Chandra L. Ford |
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| Rok vydání: | 2017 |
| Předmět: |
Gerontology
Male Health Information Exchange Cross-sectional study Ethnic group Psychological intervention HIV Infections California 0302 clinical medicine Odds Ratio Ethnicity Medicine Pharmacology (medical) 030212 general & internal medicine African Americans Medical record Hispanic or Latino Viral Load Middle Aged Continuity of Patient Care Infectious Diseases Public Health and Health Services HIV/AIDS Female Hispanic Americans 0305 other medical science Infection Viral load Adult Anti-HIV Agents Clinical Trials and Supportive Activities Clinical Sciences Ethnic Groups Article Medication Adherence 03 medical and health sciences Acquired immunodeficiency syndrome (AIDS) Clinical Research Virology Behavioral and Social Science Humans Healthcare Disparities 030505 public health business.industry Prevention Odds ratio Health Status Disparities medicine.disease Confidence interval Black or African American Cross-Sectional Studies Good Health and Well Being business |
| Zdroj: | Journal of acquired immune deficiency syndromes (1999), vol 75, iss 3 Cunningham, WE; Ford, CL; Kinsler, JJ; Seiden, D; Andrews, L; Nakazono, T; et al.(2017). Effects of a Laboratory Health Information Exchange Intervention on Antiretroviral Therapy Use, Viral Suppression, and Racial/Ethnic Disparities.. Journal of acquired immune deficiency syndromes (1999), 75(3), 290-298. doi: 10.1097/QAI.0000000000001385. UCLA: Retrieved from: http://www.escholarship.org/uc/item/1nr4987t |
| DOI: | 10.1097/QAI.0000000000001385. |
| Popis: | Author(s): Cunningham, William E; Ford, Chandra L; Kinsler, Janni J; Seiden, Danielle; Andrews, Laral; Nakazono, Terry; Bell, Douglas S | Abstract: BackgroundAlthough antiretroviral therapy (ART) is available to treat HIV+ persons and prevent transmission, ineffective delivery of care may delay ART use, impede viral suppression (VS), and contribute to racial/ethnic disparities along the continuum of care. This study tested the effects of a bi-directional laboratory health information exchange (LHIE) intervention on each of these outcomes.MethodsWe used a quasi-experimental, interrupted time-series design to examine whether the LHIE intervention improved ART use and VS, and reduced racial/ethnic disparities in these outcomes among HIV+ patients (N = 1181) in a comprehensive HIV/AIDS clinic in Southern California. Main outcome measures were ART pharmacy fill and HIV viral load laboratory data extracted from the medical records over 3 years. Race/ethnicity and an indicator for the intervention (after vs. before) were the main predictors. The analysis involved 3-stage, multivariable logistic regression with generalized estimating equations.ResultsOverall, the intervention predicted greater odds of ART use (odds ratio [OR] = 2.50; 95% confidence interval: 2.29 to 2.73; P l 0.001) and VS (OR = 1.12; 95% confidence interval: 1.04 to 1.21; P l 0.05) in the final models that included sociodemographic, behavioral, and clinical covariates. Before the intervention, there were significant black/white disparities in ART use OR = 0.75 (0.58-0.98; P = 0.04) and VS OR = 0.75 (0.61-0.92; P = 0.001). After the intervention, the black/white disparities decreased after adjusting for sociodemographics and the number of HIV care visits, and Latinos had greater odds than whites of ART use and VS, adjusting for covariates.ConclusionsThe intervention improved overall ART treatment and VS, and reduced black/white disparities. LHIE interventions may hold promise if implemented among similar patients. |
| Databáze: | OpenAIRE |
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