Benchmarking HIV Quality Measures in the US OPERA HIV Cohort. (30th September 2019)

• Record Type: Journal Article
• Authors: Heglar, Robert; Mood, Rodney; Priest, Julie L; Schulman, Kathy L; Fusco, Gregory P
• Is Part Of: Open forum infectious diseases. Volume 6:Number 10(2019)
• Publication Date: 2019-09-30
• Subjects: antiretroviral therapy -- benchmarking -- National Quality Forum -- retention in care -- quality measures; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofz418
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Quality measures are effective tools to improve patient outreach, retention in care, adherence, and outcomes. This study benchmarks National Quality Forum–endorsed HIV quality measures in a US clinical cohort. Methods: This observational study utilized prospectively captured data from the Observational Pharmaco-Epidemiology Research and Analysis (OPERA) database over 2014−2016 to assess quality measure achievement among patients with HIV in terms of medical visit frequency (#2079), medical visit gaps (#2080), viral suppression (#2082), and antiretroviral therapy (ART) prescriptions (#2083). The proportion of patients meeting each measure was calculated. Generalized estimating equations assessed trends in measure achievement. Results: The OPERA sample included 23 059−42 285 patients with similar demographics and characteristics across measurement periods. Overall, 62%−66% of patients met the visit frequency measure (#2079), 81%−85% had no gaps between visits (#2080), 71%−73% achieved viral suppression (#2082), and 92%−94% were prescribed ART (#2083). The adjusted odds of achieving viral suppression and being prescribed ART increased over time by 3% and 19%, respectively, despite a significant decline in patient engagement (16% for #2079, 25% for #2080). Patients <30 years of age were significantly less likely to meet all measures than older patients ( P < .0001), with particularly low levels of engagement. Measure achievement also varied by gender, ethnicity, region, and select clinical characteristics. Conclusions: Despite gains in the rate of ART prescription and viral suppression, there remains room for improvement in the care of patients with HIV. Strategies for quality improvement may be more effective if tailored by age group.