Feasibility of identifying out of care HIV-positive patients in a hospital setting and enrolling them in a retention intervention.
Feasibility of identifying out of care HIV-positive patients in a hospital setting and enrolling them in a retention intervention.
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DOI：
10.1080/15284336.2017.1287536
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发表时间：
2017-03
影响因子：
--
通讯作者：
Giordano TP
中科院分区：
文献类型：
--
作者：
Davila JA;Hartman C;Cully J;Stanley M;Amico KR;Soriano E;Minick S;May SB;Giordano TP
医院环境为让艾滋病毒感染者 (PLWH) 重新接受艾滋病毒护理提供了机会。我们制定并实施了一项协议来识别医院环境中的感染者。本研究的目的是报告我们招募住院艾滋病毒患者参与干预研究的策略，并报告为未来研究吸取的经验教训。我们的方案是根据我们的研究人员招募艾滋病毒患者的经验以及提供者和管理人员在住院环境中提供护理的临床意见而制定的。我们确定了 2010 年至 2013 年间住院的 PLWH，他们可能有资格参加干预研究。通过审查电子病历和临床医生转诊来识别患者，然后进行亲自筛查以确认资格。我们研究了与识别和登记住院患者相关的因素，并记录了经验教训。关键策略包括系统的病历审查、随后的亲自筛选、与员工的合作以及招聘后勤的灵活性。我们确定了 1,801 名 PLWH 在 3 年研究期间住院。 84% (n=1,514) 符合基于病历审查的纳入标准。其中，48% (n=733) 不符合资格。在符合条件的患者中，有 59% (n=460) 被纳入。只有 3% (n=23) 符合条件的患者拒绝接受治疗； 84% (n=321) 没有入学，因为他们在入学前已出院。汲取的经验教训包括 1) 需要在出院前识别患者并提供干预措施，2) 限制干预措施的复杂性，以及 3) 让研究人员在周末和下班后提供服务。有针对性地招募住院人群是寻找和吸引新诊断或不接受常规护理的感染者的可行且富有成效的方法。
The hospital setting provides an opportunity to re-engage people living with HIV (PLWH) in HIV care. We developed and implemented a protocol to identify PLWH in a hospital setting. The aim of the current study was to report on our strategy to recruit hospitalized HIV patients into an intervention study, and to report on lessons learned for future studies. Our protocol was developed based on experience of our research staff in recruiting HIV patients as well as clinical input from providers and administrators on delivering care in hospitalized settings. We identified hospitalized PLWH between 2010 and 2013 who were potentially eligible for an intervention study. Patients were identified by review of electronic medical records and clinician referral, followed by in-person screening to confirm eligibility. We examined factors related to identifying and enrolling hospitalized patients, and documented lessons learned. Key strategies included systematic medical record review followed by in-person screening, collaboration with staff, and flexibility in recruitment logistics. We identified 1,801 PLWH hospitalized during the 3-year study period. 84% (n=1,514) met the met the inclusion criteria based on medical record review. Of these, 48% (n=733) were ineligible. Among eligible patients, 59% (n=460) were enrolled. Only 3% (n=23) of eligible patients declined; 84% (n=321) were not enrolled because they were discharged before enrollment. Lessons learned included 1) needing to identify patients and deliver the intervention before hospital discharge, 2) limiting the complexity of the intervention, and 3) having research staff available on weekends and after hours. Targeted recruitment of hospitalized populations is a feasible and productive approach for finding and engaging PLWH who are newly diagnosed or out of routine care.
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