Agustí Cristina, Cunillera Oriol, Almeda Jesús, Mascort Juanjo, Carrillo Ricard, Olmos Carmen, Montoliu Alexandra, Alberny Mireia, Molina Izarbe, Cayuelas Laia, Casabona Jordi
Centre of Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalunya (CEEISCAT), Department of Health, Generalitat of Catalunya, Badalona, Spain.
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
HIV Med. 2022 Sep;23(8):868-879. doi: 10.1111/hiv.13270. Epub 2022 Mar 13.
The aim of this study was to assess the efficacy of an electronic reminder in primary healthcare in patients diagnosed with an indicator condition (IC) to improve HIV screening.
We developed a prospective interventional study in 51 primary healthcare centres in Barcelona randomly assigned into one of two study groups: control and alert. Between June 2018 and May 2019, an electronic reminder appeared in the electronic medical record each time a diagnosis of an IC in patients aged 16-65 years was registered in the alert group. We assessed HIV testing rates within 4 months following the diagnosis of an IC.
In all, 13 000 patients were diagnosed with at least one IC. HIV testing was more likely in the alert group than in the control group. The electronic reminder multiplied the odds of being tested in men by 1.26 [95% confidence interval (CI): 1.04-1.52, p = 0.019], by 1.77 (95% CI: 1.33-2.38, p < 0.001) among patients aged < 50 years , and by 1.51 (95% CI: 1.20-1.92, p < 0.001) in diagnoses of IC other than a sexually transmitted infection (STI) or an AIDS-defining illness. Five (0.08%) cases of HIV were detected in the control group and 10 (0.17%) in the alert group.
Implementing an electronic reminder had a positive impact on HIV screening rates in patients diagnosed with an IC. The alert was more effective among older patients, those living in less socioeconomically deprived neighbourhoods, and those with an IC other than an STI or an AIDS-defining illness.
本研究旨在评估电子提醒在初级医疗保健中对诊断为指标性疾病（IC）的患者进行HIV筛查的效果。
我们在巴塞罗那的51个初级医疗保健中心开展了一项前瞻性干预研究，将这些中心随机分为两个研究组：对照组和提醒组。在2018年6月至2019年5月期间，提醒组中每当登记了16至65岁患者的IC诊断时，电子提醒就会出现在电子病历中。我们评估了IC诊断后4个月内的HIV检测率。
共有13000名患者被诊断患有至少一种IC。提醒组的HIV检测率高于对照组。电子提醒使男性接受检测的几率提高了1.26倍[95%置信区间（CI）：1.04 - 1.52，p = 0.019]，在年龄小于50岁的患者中提高了1.77倍（95% CI：1.33 - 2.38，p < 0.001），在诊断为非性传播感染（STI）或艾滋病界定疾病的IC患者中提高了1.51倍（95% CI：1.20 - 1.92，p < 0.001）。对照组检测出5例（0.08%）HIV病例，提醒组检测出10例（0.17%）。
实施电子提醒对诊断为IC的患者的HIV筛查率有积极影响。提醒在老年患者、居住在社会经济剥夺程度较低社区的患者以及诊断为非STI或艾滋病界定疾病的IC患者中更有效。
