TELEMEDICINE and HIV CARE QUALITY MEASURES during the COVID-19 PANDEMIC
Topics in Antiviral Medicine
; 30(1 SUPPL):377-378, 2022.
Article
in English
| EMBASE | ID: covidwho-1880557
ABSTRACT
Background:
During the COVID-19 pandemic, HIV care providers urgently adopted telemedicine as an alternative to routine in-person person visits to ensure continuity of care. We examined how introducing televisits at a community and an academic outpatient HIV clinic during the COVID-19 pandemic affected technical quality of care for persons with HIV (PWH).Methods:
The study included all non-pregnant adult PWH who had at least two visits for HIV care in the 18 months prior to 3/13/2020 at the Howard Brown Health Centers (HB) and Northwestern University Infectious Disease Center (NU-IDC) and in Chicago, Illinois. HIV care quality indicators (described in Table) were calculated using data extracted from electronic medical records during 4 different time periods 1. pre-pandemic (1/1/19-3/1/2020), 2. early pandemic (7/1/2019-9/1/2020), 3. mid-pandemic (1/1/2020-3/1/2021), and 4. current (7/1/2020-9/1/2021). Measures were compared between intervals 2-4 and interval 1 (pre-pandemic) using generalized linear mixed models to estimate differences in indicators across intervals within each site while controlling for multiple observations of individuals. Differences by age group, race, and sex at birth were also compared.Results:
6,447 PWH were included in the analysis. The proportion of televisits peaked between April-June 2020 (71-75% at HB 53-89% at NU-IDC) then declined by July-September (33-35%at HB, 10-15% at NU). Changes in quality care measures are shown in Table 1. There were significant declines in care utilization and disease monitoring measures in intervals 2,3 &4 compared to interval 1. The largest declines were observed in STI screening. Measures of HIV virologic suppression, BP control, and HbA1C <7% (in both persons with and without diabetes) were stable with no significant differences noted in these measures between interval 4 and 1. Similar trends were observed across all age, race and sex subgroups.Conclusion:
During the COVID-19 pandemic and rapid implementation of televisits, indicators of care utilization and disease monitoring decreased compared to pre-pandemic levels. Despite these reductions, proportions with virologic, BP, and glycemic control remained stable among PWH. The effect of televisits as well as other patient factors on HIV quality indicators and their changes over time during COVID-19 need to be further examined.
hemoglobin A1c; adult; communicable disease; conference abstract; coronavirus disease 2019; diabetes mellitus; electronic medical record; female; glycemic control; groups by age; health center; human; Human immunodeficiency virus; Illinois; major clinical study; male; nonhuman; outpatient; pandemic; race; telemedicine
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Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Topics in Antiviral Medicine
Year:
2022
Document Type:
Article
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