Enhanced inpatient rounds, appointment reminders, and patient education improved HIV care engagement following hospital discharge. (June 2018)

• Record Type: Journal Article
• Authors: Khawcharoenporn, Thana; Damronglerd, Pansachee; Chunloy, Krongtip; Sha, Beverly E
• Is Part Of: International journal of STD & AIDS. Volume 29:Number 7(2018)
• Page Start: 641
• Page End: 649
• Publication Date: 2018-06
• Subjects: Inpatient rounds -- appointment reminders -- patient education -- care engagement -- human immunodeficiency virus; Sexually transmitted diseases -- Periodicals; AIDS (Disease) -- Periodicals; 616.951
• DOI: 10.1177/0956462417749420
• Languages: English
• ISSNs: 0956-4624

Abstract

Human immunodeficiency virus (HIV) care engagement post hospital discharge is often suboptimal. Strategies to improve follow-up are needed. A quasi-experimental study was conducted among hospitalized HIV-infected patients between the period from 1 January 2013 to 30 June 2014 (preintervention period) and 1 July 2014 to 31 December 2015 (intervention period). During the intervention period, an HIV care team consisting of an Infectious Diseases physician, a nurse, a pharmacist, a social worker, and an HIV-infected volunteer made daily inpatient rounds. Prior to discharge, patients received a structured HIV education session and an outpatient appointment was scheduled for them with two telephone reminder calls following discharge. There were 240 HIV-infected patients enrolled (120 in each study period), of which the median age was 37 years (interquartile range [IQR] 28–44 years), 58% were male, 39% were newly diagnosed with HIV infection, 46% were hospitalized because of AIDS-related conditions, and the median CD4 cell count on admission was 158 cells/µl (IQR 72–382 cells/µl). The rate of HIV care engagement within 30 days after discharge was significantly higher in the intervention period compared to the preintervention period (95% versus 69%; P < 0.001). Independent factors associated with no care engagement within 30 days were patients in the preintervention period (adjusted odds ratio [aOR] 6.36; P < 0.001) and new diagnosis of HIV infection (aOR 2.77; P = 0.009). The study findings suggest that enhanced inpatient rounds, appointment reminders, and patient education were shown to be associated with improved HIV care engagement after hospital discharge. Patients with a new diagnosis of HIV infection benefit from more intense outreach. ClinicalTrials.gov Identifier: NCT02578654