Impact of the nurse-led case management program with retention in care on mortality among people with HIV-1 infection: A prospective cohort study

Ko, Nai Ying; Lai, Yi Yin; Liu, Hsiao Ying; Lee, Hsin Chun; Chang, Chia Ming; Lee, Nan Yao; Chen, Po‐Lin; Lee, Ching Chi; Ko, Wen Chien

doi:10.1016/j.ijnurstu.2012.01.004

Cited by 13 publications

(9 citation statements)

References 27 publications

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“…From our study results, we identified a few factors that may highlight underlying social determinants and influence future policy development. Firstly, case managers who were nurses proved to be more effective in mobilizing partner testing [ 16 ]. Of index participants who had nurse case managers, 42.38% (503/1187) referred partners for testing, of whom 13.72% (69/503) tested HIV-positive, compared to the 27.28%(326/1195) referral rate and 7.05% (23/326) HIV-positive in the contract staff case manager group.…”

Section: Discussionmentioning

confidence: 99%

A health communication intervention to integrate partner testing with antiretroviral therapy service among men who have sex with men in China: an observational cohort study

Lian¹,

Zhao²,

Wang

et al. 2018

BMC Public Health

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BackgroundIn China, antiretroviral therapy (ART) clinics focus on treating people living with HIV and are not required to undertake testing of high-risk populations. To improve partner testing among MSM, we implemented a health communication pilot intervention integrating partner testing with ART services. We aimed to assess the feasibility of the partner referral service and identify the predictors of both successful partner referral for HIV testing and HIV-positive test results among referred partners.MethodsThis program ran from April 2014 through December 2015 at designated ART clinics in six cities. The index participants, men living with HIV enrolled at an ART clinic, were assigned a case manager who assumed responsibility for routine ART-related counseling and mobilization of HIV-positive index participants for partner referral testing. Case managers were either nurses or contract staff. The successful referral rate was the proportion of index participants who referred a sexual partner for HIV testing. The HIV-positive partner rate was the proportion of the newly referred contacts who tested HIV-positive. Factors associated with the successful referral rate and the HIV-positive partner rate were assessed.ResultsTwo thousand three hundred eighty-two index participants were enrolled. The median age was 30 years (IQR 26–37). 829index participants (34.80%) successfully referred at least one sexual partner for screening, and 92 (11.10%) referred partners were HIV-positive. Having a hospital nurse as case manager was associated with both successful partner referral (AHR = 1.56, 95% CI = 1.36–1.80) and having a HIV-positive partner (AHR = 2.35, 95% CI = 1.45–3.92). Index participants who were married (AHR = 1.44, 95% CI = 1.20–1.73) or employed (AHR = 1.29, 95% CI = 1.11–1.49) were more likely to successfully refer a partner for testing. Stable male partner relations were more likely to result in a referred partner testing HIV-positive (AHR = 5.50, 95% CI = 1.85–16.39).ConclusionOur findings indicated that integration of MSM partner testing with ART services via health communication was feasible. Nurses as case managers effectively encouraged index participants to refer their sexual partners for HIV testing.

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Section: Discussionmentioning

confidence: 99%

A health communication intervention to integrate partner testing with antiretroviral therapy service among men who have sex with men in China: an observational cohort study

Lian¹,

Zhao²,

Wang

et al. 2018

BMC Public Health

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“…[28][29][30][31][32] Given the increasing pressure to manage large panels of complex patients in a manner that produces optimal outcomes with minimal use of resources, identifying ways to conduct population-level triage remains critical. In addition to predicting the magnitude of risk for missing the next appointment, this tool stratified a large cohort of over 500 patients with unsuppressed viremia based on severity of risk.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, this study sought to determine whether a tool previously operationalized to stratify patients according to virologic failure risk at 1 year 27 could also stratify patients based on the risk of a related and potentially more immediate event: missing their next HIV primary care visit. Systematic risk assessment could support targeting of limited resources and interventions shown to improve engagement in care, such as enhanced case management, [28][29][30] to those at highest risk.…”

Section: Aids Patient Care and Stdsmentioning

confidence: 99%

Risk Prediction Tool for Medical Appointment Attendance Among HIV-Infected Persons with Unsuppressed Viremia

Woodward

Person²,

Rebeiro³

et al. 2015

AIDS Patient Care and STDs

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Successful treatment of HIV infection requires regular clinical follow-up. A previously published risk-prediction tool (RPT) utilizing data from the electronic health record (EHR) including medication adherence, previous appointment attendance, substance abuse, recent CD4 + count, prior antiretroviral therapy (ART) exposure, prior treatment failure, and recent HIV-1 viral load (VL) has been shown to predict virologic failure at 1 year. If this same tool could be used to predict the more immediate event of appointment attendance, high-risk patients could be identified and interventions could be targeted to improve this outcome. We conducted an observational cohort study at the Vanderbilt Comprehensive Care Clinic from August 2013 through March 2014. Patients with routine medical appointments and most recent HIV-1 VL > 200 copies/mL were included. Risk scores for a modified RPT were calculated based on data from the EHR. Odds ratios (OR) for missing the next appointment were estimated using multivariable logistic regression. Among 510 persons included, median age was 39 years, 74% were male, 55% were black, median CD4 + count was 327 cells/mm 3 [Interquartile Range (IQR): 142-560], and median HIV-1 VL was 21,818 copies/mL (IQR: 2,030-69,597). Medium [OR 3.95, 95% confidence interval (CI) 2.08-7.50, p-value < 0.01] and high (OR 9.55,, p-value < 0.01) vs. low RPT risk scores were independently associated with missing the next appointment. RPT scores, constructed using readily available data, allow for risk-stratification of HIV medical appointment non-attendance and could support targeting limited resources to improve appointment adherence in groups most at-risk of poor HIV outcomes.

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“…Previous studies have demonstrated that case management is associated with better retention and survival of patients with HIV [11,12]. However, case management has been differently operationalized and which specific intervention by case managers improve patients’ prognosis has not been fully elucidated [13,14].…”

Section: Discussionmentioning

confidence: 99%

Implementation of Mental Health Service Has an Impact on Retention in HIV Care: A Nested Case-Control Study in a Japanese HIV Care Facility

et al. 2013

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BackgroundPoor retention in the care of patients with human immunodeficiency virus (HIV) is associated with adverse patient outcomes such as antiretroviral therapy failure and death. Therefore, appropriate case management is required for better patient retention; however, which intervention in case management is important has not been fully investigated. Meanwhile, in Japan, each local government is required to organize mental health services for patients with HIV so that a case manager at an HIV care facility can utilize them, but little is known about the association between implementation of the services and loss to follow-up. Therefore, we investigated that by a nested case-control study.MethodsThe target population consisted of all patients with HIV who visited Osaka National Hospital, the largest HIV care facility in western Japan, between 2000 and 2010. Loss to follow-up was defined as not returning for follow-up care more than 1 year after the last visit. Independent variables included patient demographics, characteristics of the disease and treatment, and whether the patients have received mental health services. For each case, three controls were randomly selected and matched.ResultsOf the 1620 eligible patients, 88 loss to follow-up cases were identified and 264 controls were matched. Multivariate-adjusted conditional logistic regression revealed that loss to follow-up was less frequent among patients who had received mental health services implemented by their case managers (adjusted odds ratio [95% confidence interval] 0.35 [0.16-0.76]). Loss to follow-up also occurred more frequently in patients who did not receive antiretroviral therapy (adjusted odds ratio [95% confidence interval], 7.51 [3.34-16.9]), who were under 30 years old (2.74 [1.36-5.50]), or who were without jobs (3.38 [1.58-7.23]).ConclusionMental health service implementation by case managers has a significant impact on patient retention.

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Impact of the nurse-led case management program with retention in care on mortality among people with HIV-1 infection: A prospective cohort study

Cited by 13 publications

References 27 publications

A health communication intervention to integrate partner testing with antiretroviral therapy service among men who have sex with men in China: an observational cohort study

A health communication intervention to integrate partner testing with antiretroviral therapy service among men who have sex with men in China: an observational cohort study

Risk Prediction Tool for Medical Appointment Attendance Among HIV-Infected Persons with Unsuppressed Viremia

Implementation of Mental Health Service Has an Impact on Retention in HIV Care: A Nested Case-Control Study in a Japanese HIV Care Facility

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