Evidence map›Paper›PMID 26412842›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2015

Does general practice deliver safe primary care to people living with HIV? A case-notes review.

Rosie Wellesley, Alice Whittle, Jose Figueroa, Jane Anderson, Richard Castles, Kambiz Boomla, Chris Griffiths, Werner Leber

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Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Patient safety research in primary care: where are we now?The British journal of general practice : the journal of the Royal College of General Practitioners · 2015
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Rosie WellesleyCentre for Primary Care and Public Health, Queen Mary University of London, London.
Alice WhittleNHS City and Hackney PCT, London.
Jose FigueroaNHS City and Hackney PCT, London.
Jane AndersonCentre for the Study of Sexual Health and HIV;
Richard CastlesJonathan Mann Centre, Homerton University Hospital NHS Foundation Trust, London.
Kambiz BoomlaCentre for Primary Care and Public Health, Queen Mary University of London, London.
Chris GriffithsCentre for Primary Care and Public Health, Queen Mary University of London, London.
Werner LeberCentre for Primary Care and Public Health, Queen Mary University of London, London.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSafe care in general practice for people living with HIV requires early diagnosis of undetected infection and safe co-prescribing with antiretroviral therapy (ART).

aimTo evaluate safe co-prescribing in general practice patients who are taking ART, and to describe missed diagnostic opportunities for undiagnosed HIV infection in primary care. DESIGN AND

settingRetrospective case-notes review in general practices within NHS City and Hackney Primary Care Trust (PCT), London, UK.

methodAll general practices in NHS City and Hackney PCT were invited to participate. Patients known to be HIV positive were identified using Read Codes. Each practice undertook retrospective case-notes reviews on specialist correspondence, coding of ART, prescribing of common contraindicated drug pairings, and missed opportunities for HIV diagnosis.

resultsIn total, 31/44 (70.5%) practices participated, and 1022 people living with HIV were identified. Practices had received HIV clinic letters for 698 of those 1022 (68.3%) patients in the previous 12 months. Of the 787 patients known to be prescribed ART, only 413 (52.5%) had correct drug codes recorded; 32/787 (4.1%) were receiving specified contraindicated drug pairings. In total, 89 patients were eligible for their case-notes to undergo a retrospective review of occurrences that took place pre-diagnosis. In the 2 years preceding diagnosis, these 89 had attended 716 face-to-face GP consultations, of which 123 (17.2%) were for indicator conditions. Fifty-one of these patients (57.3%) presented at least once with an indicator condition (interquartile range 1-3; median 2).

conclusionIn a large-scale evaluation of GP records of people living with HIV, gaps in ART recording and co-prescribing were identified, and evidence demonstrated missed opportunities for diagnosis within general practice. Specialists and generalists must communicate better to enhance safe prescribing and reduce delayed diagnosis.

Indexed as

Physicians, Primary CareAnti-HIV AgentsAttitude of Health PersonnelDelayed DiagnosisDrug InteractionsEarly DiagnosisGeneral PracticeHealth Knowledge, Attitudes, PracticeHIV InfectionsHumansLondonMedical Records Systems, ComputerizedPractice Patterns, Physicians'Retrospective StudiesAnti-HIV Agentsdelayed diagnosisdrug interactionsgeneral practiceHIVinappropriate prescribing

Identifiers

PMID26412842
PMCPMC4582878

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.