Evidence map›Paper›PMID 36424550›Full record

Trial reportBMC primary care2022

HIV retention in care: results and lessons learned from the Positive Pathways Implementation Trial.

Michael B Wohlfeiler, Rachel Palmieri Weber, Laurence Brunet, Jennifer S Fusco, Christine Uranaka, Quateka Cochran, Monica Palma, Tammeka Evans, Carl Millner, Gregory P Fusco

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC primary care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04147832 (Epividian, Inc. and AIDS Healthcare Foundation), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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.

NCT04147832 completednot on this map

Epividian, Inc. and AIDS Healthcare Foundation: Positive Pathways - HIV Retention in Care RIC-20190212 (Pro00037143)

TypeobservationalSponsorEpividianRan2020 to 2021Enrolled10,521ConditionsHIV/AIDSArmsAlert to provider
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Exploring the Feasibility of an Electronic Tool for Predicting Retention in HIV Care: Provider Perspectives.International journal of environmental research and public health · 2024
    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

10 authors.

Michael B WohlfeilerAIDS Healthcare Foundation, Los Angeles, CA, USA.
Rachel Palmieri WeberEpividian Inc., Raleigh, NC, USA. rachel.weber@epividian.com.
Laurence BrunetEpividian Inc., Raleigh, NC, USA.
Jennifer S FuscoEpividian Inc., Raleigh, NC, USA.
Christine UranakaAIDS Healthcare Foundation, Los Angeles, CA, USA.
Quateka CochranAIDS Healthcare Foundation, Los Angeles, CA, USA.
Monica PalmaAIDS Healthcare Foundation, Los Angeles, CA, USA.
Tammeka EvansViiV Healthcare, Durham, NC, USA.
Carl MillnerAIDS Healthcare Foundation, Los Angeles, CA, USA.
Gregory P FuscoEpividian Inc., Raleigh, NC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSustained, routine care is vital to the health of people with HIV (PWH) and decreasing transmission of HIV. We evaluated whether the identification of PWH at-risk of falling out of care and prompts for outreach were effective in retaining PWH in care in the United States.

methodsIn this cluster randomized controlled trial, 20 AIDS Healthcare Foundation Healthcare Centers (HCCs) were randomized to the intervention (n = 10) or control (n = 10) arm; all maintained existing retention efforts. The intervention included daily automated flags in CHORUS™, a mobile app and web-based reporting solution utilizing electronic health record data, that identified PWH at-risk of falling out of care to clinic staff. Among flagged PWH, the association between the intervention and visits after a flag was assessed using logistic regression models fit with generalized estimating equations (independent correlation structure) to account for clustering. To adjust for differences between HCCs, models included geographic region, number of PWH at HCC, and proportions of PWH who self-identified as Hispanic or had the Ryan White Program as a payer.

resultsOf 15,875 PWH in care, 56% were flagged; 76% (intervention) and 75% (control) resulted in a visit, of which 76% were within 2 months of the flag. In adjusted analyses, flags had higher odds of being followed by a visit (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 0.97, 1.21) or a visit within 2 months (OR: 1.07, 95% CI: 0.97, 1.17) at intervention than control HCCs. Among at-risk PWH with viral loads at baseline and study end, the proportion with < 50 copies/mL increased in both study arms, but more so at intervention (65% to 74%) than control (62% to 67%) HCCs.

conclusionDespite challenges of the COVID-19 pandemic, adding an intervention to existing retention efforts, and the reality that behavior change takes time, PWH flagged as at-risk of falling out of care were marginally more likely to return for care at intervention than control HCCs and a greater proportion achieved undetectability. Sustained use of the retention module in CHORUS™ has the potential to streamline retention efforts, retain more PWH in care, and ultimately decrease transmission of HIV.

trial registrationThe study was first registered at Clinical Trials.gov (NCT04147832, https://clinicaltrials.gov/show/NCT04147832 ) on 01/11/2019.

Indexed as

Continuity of Patient CareHIV InfectionsRetention in CareAmbulatory Care FacilitiesCarcinoma, HepatocellularCOVID-19Decision Support Systems, ClinicalHumansLiver NeoplasmsPandemicsUnited StatesAlertsClinical Decision Support SystemHIVHIV Treatment and PreventionRe-engagementRetention in Care

Identifiers

PMID36424550
PMCPMC9685944

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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.