Cascade Monitoring in Multidisciplinary Adolescent HIV Care Settings: Protocol for Utilizing Electronic Health Records
Cascade Monitoring in Multidisciplinary Adolescent HIV Care Settings: Protocol for Utilizing Electronic Health Records
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DOI：
10.2196/11185
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发表时间：
2019-05-01
影响因子：
1.7
通讯作者：
Naar, Sylvie
中科院分区：
文献类型：
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作者：
Pennar, Amy L.;Dark, Tyra;Naar, Sylvie
背景：过去的研究表明，青年艾滋病毒感染者（YLH）不像其他艾滋病毒阳性人群那样参与艾滋病毒治疗级联。为了实现快速和广泛的测试和先进的药物治疗的健康效益，YLH必须充分参与治疗级联的每个阶段。级联监测提供了一个机会，以评估青少年护理级联，包括在护理的参与，当青年通常退出护理，在10个临床网站在美国。通过在青少年医学试验网络（ATN）内的参与者招募地点收集用于预防和护理的电子健康记录（EHR）数据，可以监测ATN内的预防和护理级联，将ATN人群与大规模监测进行比较，将来将基于技术的干预措施整合到EHR中，并为ATN战略规划提供信息。目标：本方案研究的目的是检查治疗级联的趋势，包括患者是否接受抗逆转录病毒治疗，坚持治疗方案，参加护理预约和维持抑制的病毒载量，以指导新方案的制定并促进社区参与。该协议是ATN规模它了（SIU）程序的一部分，在这个issue.Methods中描述：YLH，年龄在15至24岁，将每年（2017年至2022年）从10个ATN临床站点收集未识别的EHR数据，从而从2016年至2021年的患者数据。这些数据将通过Dropbox Business传输和存储，然后由SIU分析核心进行分析。结果：本研究于2017年12月在10家临床研究中心启动，2016年的EHR数据将于2017年1月31日提交。所有10个研究中心都以电子方式上传了其EHR数据。监测级联护理所需的强制性变量包括就诊日期、年龄、性别、身高、体重、人种、种族、病毒载量和其他诊断的国际疾病分类代码。总体而言，70%的研究中心提供了所有强制变量的数据。其余的强制性变量手动extracted.Conclusions：这项研究将提供一个平台，以确定如何YLH全国各地的进展，通过或退出艾滋病毒治疗级联。它还将为评估SIU项目对治疗级联结果的影响提供基础。
Background: Past research shows that youth living with HIV (YLH) are not as engaged in the HIV treatment cascade as other HIV-positive populations. To achieve the health benefits of rapid and widespread testing and advanced pharmacologic treatment, YLH must be fully engaged in every stage of the treatment cascade. Cascade monitoring provides an opportunity to assess the youth care cascade, including engagement in care and when youth commonly drop out of care, across 10 clinical sites in the United States. Collecting electronic health record (EHR) data for prevention and care across participant recruitment venues within the Adolescent Medicine Trials Network (ATN) allows for monitoring of the prevention and care cascades within the ATN, for comparing the ATN population to large-scale surveillance, for future integration of technology based interventions into EHRs, and for informing ATN strategic planning.Objective: The aim of this protocol study is to examine the trends in treatment cascade, including whether patients are receiving antiretroviral therapy, adhering to regimens, attending care appointments, and maintaining suppressed viral loads, to guide new protocol development and to facilitate community engagement. This protocol is part of the ATN Scale It Up (SIU) program described in this issue.Methods: Deidentified EHR data of YLH, aged 15 to 24 years, will be collected annually (2017 to 2022) from 10 ATN clinical sites, resulting in patient data from 2016 to 2021. These data will be transferred and stored using Dropbox Business, a Health Insurance Portability and Accountability Act-compliant site and then analyzed by the SIU analytic core.Results: This study was launched in December 2017 in 10 clinical sites, with 2016's EHR data due on January 31, 2017. All 10 sites electronically uploaded their EHR data. The mandatory variables requested to monitor cascade of care include date of visit, age, gender, height, weight, race, ethnicity, viral load, and International Classification of Diseases codes for other diagnosis. In total, 70% of the sites provided data for all mandatory variables. The remaining mandatory variables were manually extracted.Conclusions: This study will provide a platform to determine how YLH across the nation progress through or drop out of the HIV treatment cascade. It will also provide a foundation for assessing impact of SIU projects on treatment cascade outcomes.