An electronic medical record system for ambulatory care of HIV-infected patients in Kenya

Siika, Abraham; Rotich, Joseph K.; Simiyu, Chrispinus J; Kigotho, Erica M.; Smith, Frederick; Sidle, John E.; Wools‐Kaloustian, Kara; Kimaiyo, Sylvester; Nyandiko, Winstone; Hannan, Terry J.; Tierney, William M.

doi:10.1016/j.ijmedinf.2005.03.002

Cited by 96 publications

(94 citation statements)

References 10 publications

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“…Of those attending routine psychosocial support groups during the study week at Moi University Teaching and Referral Hospital in Eldoret, Kenya, 100% agreed to participate when invited by a research assistant 32 . These support groups are a component of a comprehensive HIV prevention and care program known as the Academic Model for the Prevention and Treatment of HIV/AIDS (AMPATH) [81][82][83][84] .…”

Section: Participant Recruitmentmentioning

confidence: 99%

Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya

et al. 2008

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BACKGROUND: Depression greatly burdens subSaharan Africa, especially populations living with HIV/ AIDS, for whom few validated depression scales exist. Patient Health Questionnaire-9 (PHQ-9), a brief dualpurpose instrument yielding DSM-IV diagnoses and severity, and PHQ-2, an ultra-brief screening tool, offer advantages in resource-constrained settings. OBJECTIVE:To assess the validity/reliability of PHQ-9 and PHQ-2. DESIGN: Observational, two occasions 7 days apart.PARTICIPANTS: A total of 347 patients attending psychosocial support groups.MEASUREMENTS: Demographics, PHQ-9, PHQ-2, general health perception rating and CD4 count. RESULTS:Rates for PHQ-9 DSM-IV major depressive disorder (MDD), other depressive disorder (ODD) and any depressive disorder were 13%, 21% and 34%. Depression was associated with female gender, but not CD4. Construct validity was supported by: (1) a strong association between PHQ-9 and general health rating, (2) a single major factor with loadings exceeding 0.50, (3) item-total correlations exceeding 0.37 and (4) a pattern of item means similar to US validation studies. Four focus groups indicated culturally relevant content validity and minor modifications to the PHQ-9 instructions. Coefficient alpha was 0.78. Test-retest reliability was acceptable: (1) intraclass correlation 0.59 for PHQ-9 total score, (2) kappas 0.24, 0.25 and 0.38 for PHQ-9 MDD, ODD and any depressive disorder and (3) weighted kappa 0.53 for PHQ-9 depression severity categories. PHQ-2 ≥3 demonstrated high sensitivity (85%) and specificity (95%) for diagnosing any PHQ-9 depressive disorder (AUC, 0.97), and 91% and 77%, respectively, for diagnosing PHQ-9 MDD (AUC, 0.91). Psychometrics were also good within four gender/age (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) subgroups.CONCLUSIONS: PHQ-9 and PHQ-2 appear valid/ reliable for assessing DSM-IV depressive disorders and depression severity among adults living with HIV/AIDS in western Kenya. INTRODUCTIONMore than 70% of all deaths attributable to HIV/AIDS are in sub-Saharan Africa, with approximately 6.1% of adults living with HIV in Kenya in 2005 1 . The social, economic and health impact of depression in sub-Saharan Africa is also great, where depression is associated with mortality 2-5 , work disability 4-7 , lower quality of life 5,[8][9][10][11][12] , risk of heart disease 13 and high-risk behaviors for contracting HIV infection 14 . With one exception 15 , the sparse literature on depression among individuals living with HIV/AIDS in sub-Saharan Africa has shown elevated rates of depression relative to community samples 3,8,10,[16][17][18][19][20][21][22][23][24][25] , consistent with western countries [26][27][28][29] . Thus, there is an urgency to incorporating mental health into HIV/ AIDS treatment programs in sub-Saharan Africa, including western Kenya [30][31][32][33][34][35] .Depression in sub-Saharan Africa presents in forms (culturespecific idioms, somatic, based on interpersonal relationships or spiritual in nature) that may o...

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Section: Participant Recruitmentmentioning

confidence: 99%

Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya

et al. 2008

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“…18 The Kenyan ITMI fellows and their IU and Regenstrief colleagues modified the smaller MMRS and, in 2001 launched the AMPATH Medical Record System (AMRS) to both serve AMPATH's clinical mission and provide data for retrospective and prospective research. 19 By 2002, AMPATH had opened HIV/AIDS clinics at three additional rural health centers and enrolled a total of 800 HIV-infected patients. At this point, AMPATH's leaders decided that a formal research program needed to be actively developed and recruited two of the authors to lead it: the Regenstrief investigator (WMT) who directed the Moi-Regenstrief ITMI Fellowship Program and AMPATH's Director of Paediatrics (WNN).…”

Section: Program Beginnings and Early Historymentioning

confidence: 99%

“These are Good Problems to Have…”: Establishing a Collaborative Research Partnership in East Africa

et al. 2013

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“…5,14 An electronic medical record system developed and implemented in Kenya used an eight-page initial visit encounter form and a two-page return visit encounter form. 9 Our concise onepage Baseline History and Longitudinal Visit forms were well received by treating physicians and significantly reduced costs on consumables (reduced photocopying costs) and quality assurance as they had minimal free text thus generating fewer queries and requiring less data manager supervision. In addition, the majority of the queries were not complicated as they could be handled at the data keying and physician level.…”

Section: Lessons Learned Which Data Should Be Collected?mentioning

confidence: 99%

“…5,6 There is a paucity of data on the lessons learned and best method to monitor and evaluate the outcomes of patients initiated on HAART in subSaharan Africa. [8][9][10][11] Well-designed and integrated "longitudinal" data capture and tracking systems are vital for the successful and sustainable implementation of ART programmes at the level of the patient and in the broader public health perspective. We developed a concise hybrid "paper-electronic" patient documentation system, which makes use of optical character recognition (OCR) technology, at Princess Marina Hospital in Gaborone, Botswana's largest tertiary referral hospital and the first public HAART outpatient clinic.…”

Section: Introductionmentioning

confidence: 99%

Hybrid data capture approach for monitoring HAART patients

Bussmann

Wester

Ndwapi

et al. 2006

Bull World Health Organ

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Individual patient care and programme evaluation are pivotal for the success of antiretroviral treatment programmes in resource-limited countries. While computer-aided documentation and data storage are indispensable for any large programme, several important issues need to be addressed including which data are to be collected, who collects it and how it is entered into an electronic database. We describe a patient-monitoring approach, which uses patient encounter forms (in hybrid paper + electronic format) based on optical character recognition, piloted at Princess Marina Hospital in Gaborone, Botswana's first public highly active antiretroviral therapy (HAART) outpatient clinic. Our novel data capture approach collects "key" data for tracking patient and programme outcomes. It saves physician time and does not detract from clinical care. Voir page 131 le résumé en français. En la página 131 figura un resumen en español. Keywords

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An electronic medical record system for ambulatory care of HIV-infected patients in Kenya

Cited by 96 publications

References 10 publications

Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya

Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya

“These are Good Problems to Have…”: Establishing a Collaborative Research Partnership in East Africa

Hybrid data capture approach for monitoring HAART patients

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