This article is more than 5 years old. Information may no longer be current.
Comprehensive care coordination improved HIV outcomes
Click Here to Manage Email Alerts
Among patients with HIV who have major barriers to care, a comprehensive care coordination program may significantly improve short-term outcomes, particularly in those returning to care after more than 6 months of absence, according to recent study data.
Researchers from the New York City Department of Health and Mental Hygiene (DOHMH) evaluated the cases of 3,641 patients enrolled before 2011 into an HIV Care Coordination Program (CCP) established by the DOHMH. The CCP was established using Ryan White Part A funds, and is designed to provide support to patients at high risk for suboptimal HIV care outcomes. Eligible patients were subject to multiple interventions to improve engagement in care, including outbreak, case management, multidisciplinary care team, patient navigation and ART adherence support.
To compare patient outcomes before and after CCP, the researchers used registry-based CD4 and viral load test records (as surrogates for medical visits) to measure engagement in care and viral load suppression. Engagement in care was defined as having at least two laboratory tests a minimum of 90 days apart, with at least one test in each half of a 12-month review period. Viral load suppression was defined as no more than 200 copies/mL on the latest test in the second half of the year.
The researchers found that among newly diagnosed clients enrolled in the CCP, 90.5% (95% CI, 87.9%-93.2%) achieved engagement in care and 66.2% (95% CI, 61.9%-70.6%) achieved viral load suppression. Among previously diagnosed patients in the CCP, engagement in care increased from 73.7% to 91.3% (RR=1.24; 95% CI, 1.21-1.27) and viral load suppression improved from 32.3% to 50.9% (RR=1.58; 95% CI, 1.5-1.66). The greatest overall improvement was seen in patients without evidence of HIV care during the previous 6 months.
“It is particularly encouraging that observed improvements for the previously diagnosed held across subgroups defined by baseline care status, as well as most demographic or clinical/ treatment experience categories,” the researchers wrote. “Despite the limitations of an observational pre-post design, our initial analyses of short-term CCP client outcomes suggest the promise of this comprehensive combination interventional model for optimizing the individual and community impact of HIV care among persons at risk for suboptimal outcomes.”
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts