Using Electronic Medical Record Data to Improve HIV Primary Care

Using Electronic Medical Record Data to Improve HIV Primary Care: An Audit and Feedback Study

This cluster randomized control trial examines whether an audit and feedback study improves care of patients living with HIV/AIDS in a family health team setting.

Study Overview

• Status: Unknown
• Conditions: HIV/AIDS; Electronic Health Records; Quality of Health Care
• Intervention / Treatment: Behavioral: Audit and Feedback

Detailed Description

This cluster randomized control trial will use electronic medical record (EMR) data from the St. Michael's Hospital Academic Family Health Team to examine whether the quality of HIV care provided to patients can be improved through an audit and feedback (A&F) intervention. Our objective is to examine whether A&F targeting family physicians caring for people living with HIV/AIDS (PHLA) using EMR data can improve laboratory monitoring, engagement in primary care and the uptake of preventive interventions.

• Study Type: Interventional
• Enrollment (Actual): 13
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada, M5B1W8
      • St. Michael's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: ADULT; OLDER_ADULT; CHILD
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Family physicians at the St. Michael's Hospital Academic Family Health Team who have at least 20 PLHA.

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: HEALTH_SERVICES_RESEARCH
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention; Audit and feedback directed at family physicians, including reports a one-on-one meeting.	Behavioral: Audit and Feedback; Charts for enrolled physicians will be audited and they will receive feedback, consisting of tailored reports and one-on-one meeting with colleague to review at baseline, 3 months and 6 months
No Intervention: Control; Usual care; may receive the intervention at the end of the study if successful

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Up to date viral load	Percentage of HIV infected patients who have an up to date HIV viral load	Within six months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinic visit	To assess engagement in care	Within the last 6 months
Up-to-date cancer screenings	Presence of cancer monitoring for colorectal, breast and cervical cancers	1-3 years
Vaccinations	Up-to-date for both pneumococcal vaccines and seasonal influenza vaccine	Since 2013
Screening for diabetes	For those 40 or older, the presence of either a fasting blood glucose or HbA1c in the chart	Within 1 year
Screening for hypercholesterolemia	For those 40 or older. the presence of an LDL or non-HDL in the chart	Within 1 year
Screening for osteoporosis	For patients 50 years and older, the presence of a bone mineral density report	Within 5 years

Collaborators and Investigators

• Sponsor: Unity Health Toronto
• Investigators: Principal Investigator: Andrew Pinto, MSc MD, Unity Health Toronto

Study record dates

Study Major Dates

• Study Start (Actual): April 3, 2017
• Primary Completion (Anticipated): December 1, 2020
• Study Completion (Anticipated): December 1, 2020

Study Registration Dates

• First Submitted: May 31, 2019
• First Submitted That Met QC Criteria: September 25, 2019
• First Posted (Actual): September 27, 2019

Study Record Updates

• Last Update Posted (Actual): September 27, 2019
• Last Update Submitted That Met QC Criteria: September 25, 2019
• Last Verified: September 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: RNA Virus Infections; Virus Diseases; Infections; Blood-Borne Infections; Communicable Diseases; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; Immunologic Deficiency Syndromes; Immune System Diseases; Slow Virus Diseases; HIV Infections; Acquired Immunodeficiency Syndrome
• Other Study ID Numbers: SMH-16-381

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No