485. Enhanced Inpatient Round, Appointment Reminder and Patient Education Improved HIV Care Engagement after Hospital Discharge
Session: Poster Abstract Session: HIV Care Continuum
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Poster Linkage to Care.pdf (574.1 kB)
  • Background: Linkage to care after the diagnosis of HIV infection and care retention are essential for HIV management and transmission prevention. However, the data on HIV care engagement after hospital discharge and strategies to improve care engagement are limited.

    Methods: A quasi-experimental study was conducted among hospitalized HIV-infected patients at a Thai tertiary-care center between the period from 1 January 2013 to 30 June 2014 (pre-intervention period) and 1 July 2014 to 31 December 2015 (post-intervention period). Enhanced interventions during the post-intervention period included daily inpatient round by the HIV care team consisting of an Infectious Diseases physician, a nurse, a pharmacist, a social worker and an HIV-infected volunteer, arrangement of appointment within 30 days after discharge based on patients’ medical coverage and preferences, two telephone calls to remind the upcoming clinic appointment on day 7 after discharge and 1 day prior to the appointment and a patient education session.

    Results: There were 240 HIV-infected patients enrolled (120 in each study period). The median age was 37 years (IQR 28-44 years), 58% were male, 39% were newly-diagnosed of HIV infection, 46% were hospitalized because of AIDS-related conditions and the median CD4 cell count on admission was 158 cells/µL (IQR 72-382 cells/µL). Demographic and clinical characteristics were comparable between patients in both periods. The rate of HIV care engagement within 30 days after discharge was significantly higher in the post-intervention period compared to the pre-intervention period (95% vs. 69%; P<0.001). Independent factors associated with no care engagement within 30 days were patients in the pre-intervention period [adjusted odds ratio (aOR) 6.36; P<0.001] and new diagnosis of HIV infection (aOR 2.77; P=0.009). The three most common reasons for no care engagement were work burden (37%), need to take care of a child (16%) and feeling that they were healthy (14%).

    Conclusion: The enhanced inpatient round, appointment reminder and patient education significantly improved the HIV care engagement after hospital discharge. Patients with new diagnosis of HIV infection should be closely monitored for follow-up appointment.

    Thana Khawcharoenporn, M.D., M.Sc.1, Pansajee Damronglerd, M.D.1 and Krongtip Chunloy, R.N., MPH2, (1)Thammasat University, Pathumthani, Thailand, (2)Thammasat University Hospital, Pathumthani, Thailand

    Disclosures:

    T. Khawcharoenporn, None

    P. Damronglerd, None

    K. Chunloy, None

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