Evaluation of Adherence to Dual-Energy X-Ray Absorptiometry Scan Ordering for Persons Living with HIV at a Tertiary Medical Center.
Evaluation of Adherence to Dual-Energy X-Ray Absorptiometry Scan Ordering for Persons Living with HIV at a Tertiary Medical Center.
复制标题
对三级医疗中心艾滋病毒感染者遵守双能 X 射线吸收测定扫描预约的评估。
DOI：
10.1089/apc.2020.0250
复制
发表时间：
2021
影响因子：
4.9
通讯作者：
Krueger,KarenM
中科院分区：
文献类型：
--
作者：
Kumar,RebeccaN;Masters,MaryC;Williams,Janna;Morrison,LindsayR;Galvin,Shannon;Krueger,KarenM
(公共卫生署)。1通过脆性骨折病史或双能X射线骨密度(BMD)测量诊断，PLWH患骨质疏松症的风险更高。2、3抗逆转录病毒治疗(ART)和HIV与个体之间的相互作用都会影响BMD。5艾滋病药物协会建议对所有年龄在‡50岁的绝经后感染艾滋病病毒的女性和男性进行地塞米松筛查。6目前还没有发表报告来评估对该指南的遵守情况。本研究调查了一家大型城市三级护理中心的服务提供者的地塞米松订购行为，研究对象包括一家城市艾滋病门诊的50岁‡老人。为了获得资格，所有个人在2018年至少去过一次诊所，并被病毒抑制了抗逆转录病毒治疗。选择了一个方便的样本。非盲表回顾评估了DEXA扫描是否在任何时候被(1)订购，(2)由HIV提供者订购，(3)完成，和(4)异常。此外，还注意到在提取图表时，个体是否在服用富马酸替诺福韦(TDF)方案。该项目免于机构审查委员会的批准，因为它是为诊所的质量改进倡议而做的。
(PLWH). 1 PLWH are at higher risk for the development of osteoporosis, diagnosed by either a history of fragility fracture or dual-energy X-ray absorptiometry (DEXA) measurement of bone mineral density (BMD). 2, 3 Both antiretroviral treatment (ART) and interactions between HIV and the individual affect BMD. 4, 5 HIV Medicine Association (HIVMA) recommends DEXA screening for all HIV-infected postmenopausal women and men aged‡ 50 years. 6 There have been no published reports evaluating adherence with this guideline. This study investigates the DEXA ordering practices of providers at a large urban tertiary care center.PLWH aged‡ 50 years from a single academic urban outpatient HIV clinic were included. To qualify, all individuals had at least one clinic visit in the year 2018 and were virally suppressed on ART. A convenience sample was selected. Unblinded chart review assessed if at any time a DEXA scan was (1) ordered,(2) ordered by an HIV provider,(3) completed, and (4) abnormal. In addition, it was noted if individuals were on a tenofovir disoproxil fumarate (TDF)-containing regimen at time of chart extraction. This project was exempt from Institutional Review Board approval as it was done for a quality improvement initiative in the clinic.