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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Development and application of a new measure of engagement in out-patient HIV care
HIV Medicine, Volume 18, No. 4, Year 2017
Notification
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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. © 2016 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.
Authors & Co-Authors
Burns, Fiona M.
United Kingdom, London
University College London
United Kingdom, London
Royal Free London Nhs Foundation Trust
Apea, Vanessa J.
United Kingdom, London
Barts Health Nhs Trust
Jose, Sophie
United Kingdom, London
University College London
Hill, Teresa
United Kingdom, London
University College London
Delpech, Valerie C.
United Kingdom, London
Public Health England
Mercer, Catherine H.
United Kingdom, London
University College London
Michie, Susan F.
United Kingdom, London
University College London
Morris, Stephen Lloyd
United Kingdom, London
University College London
Sachikonye, Memory
United Kingdom, London
Uk Community Advisory Board
Sabin, Caroline Anne
United Kingdom, London
University College London
Ainsworth, Jonathan G.
Unknown Affiliation
Allan, Sris P.
Unknown Affiliation
Anderson, Jane
Unknown Affiliation
Babiker, Abdel G.A.G.
Unknown Affiliation
Chadwick, David Robert
Unknown Affiliation
Dunn, David T.
Unknown Affiliation
Fisher, Martin J.
Unknown Affiliation
Gazzard, Brian G.
Unknown Affiliation
Gilson, Richard John Cary
Unknown Affiliation
Gompels, Mark M.
Unknown Affiliation
Hay, Phillip E.
Unknown Affiliation
Johnson, Margaret A.
Unknown Affiliation
Kegg, Stephen
Unknown Affiliation
Leen, Clifford L.S.
Unknown Affiliation
Martin, Fabiola
Unknown Affiliation
Nelson, Mark Richard
Unknown Affiliation
Orkin, Chloë M.
Unknown Affiliation
Palfreeman, Adrian J.
Unknown Affiliation
Phillips, Andrew N.
Unknown Affiliation
Morris, Lynn G.
Unknown Affiliation
Post, Frank A.
Unknown Affiliation
Pritchard, Jillian
Unknown Affiliation
Schwenk, Achim
Unknown Affiliation
Tariq, Anjum
Unknown Affiliation
Trevelion, Roy
Unknown Affiliation
Walsh, John Christopher
Unknown Affiliation
Thornton, Alicia Claire
Unknown Affiliation
Huntington, Susie E.
Unknown Affiliation
Glabay, Adam J.
Unknown Affiliation
Perry, Nicky
Unknown Affiliation
Tilbury, Stuart
Unknown Affiliation
Youssef, Elaney
Unknown Affiliation
Churchill, Duncan R.
Unknown Affiliation
Everett, Rhiannon
Unknown Affiliation
Asboe, David
Unknown Affiliation
Mandalia, Sundhiya
Unknown Affiliation
Korat, Hardik
Unknown Affiliation
Taylor, Christopher B.
Unknown Affiliation
Gleisner, Zachary
Unknown Affiliation
Ibrahim, Fowzia A.
Unknown Affiliation
Campbell, Lucy J.
Unknown Affiliation
Brima, Nataliya
Unknown Affiliation
Williams, Ian G.
Unknown Affiliation
Youle, Mike S.
Unknown Affiliation
Lampe, Fiona C.
Unknown Affiliation
Smith, Colette Joanne
Unknown Affiliation
Tsintas, Robert
Unknown Affiliation
Chaloner, Clinton
Unknown Affiliation
Hutchinson, Samantha
Unknown Affiliation
Mackie, Nicky
Unknown Affiliation
Winston, Alan
Unknown Affiliation
Weber, Jonathan N.
Unknown Affiliation
Ramzan, Farhan
Unknown Affiliation
Carder, Mark
Unknown Affiliation
Lynch, Janet
Unknown Affiliation
Hand, James
Unknown Affiliation
Munshi, Sajid
Unknown Affiliation
Miller, Sheila
Unknown Affiliation
Wood, Christopher W.
Unknown Affiliation
Wilson, Alan C.
Unknown Affiliation
Memon, Khurram
Unknown Affiliation
Lewszuk, Adam Jacek
Unknown Affiliation
Gibson, Jane
Unknown Affiliation
Main, Paul
Unknown Affiliation
Dhillon, Mandip
Unknown Affiliation
Russell-Sharpe, Sarah
Unknown Affiliation
Harte, Andrew
Unknown Affiliation
Clay, Stephen
Unknown Affiliation
Spencer, Hazel
Unknown Affiliation
Jones, Ron
Unknown Affiliation
Cumming, Shirley
Unknown Affiliation
Atkinson, Claire E.
Unknown Affiliation
Statistics
Citations: 15
Authors: 82
Affiliations: 5
Identifiers
Doi:
10.1111/hiv.12427
ISSN:
14642662
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Approach
Quantitative
Participants Gender
Male