ArticlePloS one2014
Development of an electronic medical record based alert for risk of HIV treatment failure in a low-resource setting.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The use of Electronic Health Records to Support Population Health: A Systematic Review of the Literature.Journal of medical systems · 2018Pooled it
- Opportunities and challenges in developing risk prediction models with electronic health records data: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2017Pooled it
- Development and Validation of a Novel Risk Calculator to Predict Sub-optimal HIV Outcomes Among Pregnant and Postpartum Women with HIV in Kenya.AIDS and behavior · 2025Article
- Development and validation of a prediction tool to support engagement in HIV care among young people ages 10-24 years in Kenya.PloS one · 2023Article
- User Perceptions and Use of an Enhanced Electronic Health Record in Rwanda With and Without Clinical Alerts: Cross-sectional Survey.JMIR medical informatics · 2022Article
- Estimating the effect of increasing dispensing intervals on retention in care for people with HIV in Haiti.EClinicalMedicine · 2021Article
- An EMR-Based Alert with Brief Provider-Led ART Adherence Counseling: Promising Results of the InfoPlus Adherence Pilot Study Among Haitian Adults with HIV Initiating ART.AIDS and behavior · 2020Article
- Expanded access to viral load testing and use of second line regimens in Haiti: time trends from 2010-2017.BMC infectious diseases · 2020Article
- Actionable Adherence Monitoring: Technological Methods to Monitor and Support Adherence to Antiretroviral Therapy.Current HIV/AIDS reports · 2018Review
- Article
- External quality assessment for HIV rapid tests: challenges and opportunities in Haiti.BMJ global health · 2018Article
- Virologic outcome among patients receiving antiretroviral therapy at five hospitals in Haiti.PloS one · 2018Article
- Expansion of Viral Load Testing and the Potential Impact on Human Immunodeficiency Virus Drug Resistance.The Journal of infectious diseases · 2017Article
- Open-Source Electronic Health Record Systems for Low-Resource Settings: Systematic Review.JMIR medical informatics · 2017Review
- Improving antiretroviral therapy adherence in resource-limited settings at scale: a discussion of interventions and recommendations.Journal of the International AIDS Society · 2017Article
- Article
- Using Electronic Health Records for Population Health Research: A Review of Methods and Applications.Annual review of public health · 2016Review
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundThe adoption of electronic medical record systems in resource-limited settings can help clinicians monitor patients' adherence to HIV antiretroviral therapy (ART) and identify patients at risk of future ART failure, allowing resources to be targeted to those most at risk.
methodsAmong adult patients enrolled on ART from 2005-2013 at two large, public-sector hospitals in Haiti, ART failure was assessed after 6-12 months on treatment, based on the World Health Organization's immunologic and clinical criteria. We identified models for predicting ART failure based on ART adherence measures and other patient characteristics. We assessed performance of candidate models using area under the receiver operating curve, and validated results using a randomly-split data sample. The selected prediction model was used to generate a risk score, and its ability to differentiate ART failure risk over a 42-month follow-up period was tested using stratified Kaplan Meier survival curves.
resultsAmong 923 patients with CD4 results available during the period 6-12 months after ART initiation, 196 (21.2%) met ART failure criteria. The pharmacy-based proportion of days covered (PDC) measure performed best among five possible ART adherence measures at predicting ART failure. Average PDC during the first 6 months on ART was 79.0% among cases of ART failure and 88.6% among cases of non-failure (p<0.01). When additional information including sex, baseline CD4, and duration of enrollment in HIV care prior to ART initiation were added to PDC, the risk score differentiated between those who did and did not meet failure criteria over 42 months following ART initiation.
conclusionsPharmacy data are most useful for new ART adherence alerts within iSanté. Such alerts offer potential to help clinicians identify patients at high risk of ART failure so that they can be targeted with adherence support interventions, before ART failure occurs.
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