通过信息学方法改善参与艾滋病毒暴露前预防的情况 - - 过程改进项目
Jeremy J Mandia1, Case H Keltner1, Robert C Haynes1
1At the time of project completion, all authors were with Madigan Army Medical Center, Tacoma, WA. Jeremy Mandia, Case Keltner, Robert Haynes, and Luke Mease were with the Department of Preventive Medicine; Lisa Cruz is with the Department of Family Medicine; and Keith Solveson is with the Department of Informatics.
American journal of public health
|February 12, 2025
概括
已过期的HIV暴露前预防药物处方的军事医疗保健受益者通过系统的电子健康记录查询重新参与. 这种主动的方法成功地将患者的重新参与率提高了30%.
科学领域:
- 公共卫生 公共卫生
- 预防传染病 预防传染病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 保持对暴露前预防 (PrEP) 的坚持对于预防艾滋病毒至关重要.
- 过期的处方代表了在符合条件的个人中持续预防艾滋病毒的错失机会.
- 药物坚持的积极病例管理可能是资源密集的.
研究的目的:
- 重新吸引那些已经过期的HIV暴露前预防药物处方的军事医疗保健受益人.
- 评估使用电子健康记录 (EHR) 进行主动患者推广的可行性和影响.
- 在军事卫生系统内改善PrEP的遵守和覆盖范围.
主要方法:
- 对EHR的回顾性审查确定了马迪根陆军医疗中心的军方医疗保健受益者,他们的HIV PrEP处方已经过期.
- 已过期处方的患者通过电话联系,以评估艾滋病毒风险并讨论PrEP的延续.
- 对于有临床适用于PrEP的患者,进行了后续安排.
主要成果:
- 80%的临床适用于PrEP的患者同意在外展后重新参与服务.
- 该倡议导致该机构接受PrEP的患者人数增加了30%.
- 系统的EHR查询证明了减少不遵守的有效性.
结论:
- 积极,系统的EHR查询可以有效地识别和重新参与到已过期的PrEP处方患者中.
- 这种方法可以显著提高PrEP的遵守率和覆盖率,特别是当积极病例管理有限时.
- 利用EHR数据是预防艾滋病毒传播的公共卫生干预措施的宝贵策略.
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