A recent study has found
that health information exchange interventions can improve viral suppression in patients with HIV and uptake of antiretroviral therapy; these interventions can also work to reduce disparities in the continuum of care among black and white patients.
It is well documented that Blacks and Latinos are disproportionally affected by HIV, with socioeconomic and equity disparities placing these populations at a higher risk for infection. Furthermore, they are less likely to receive ongoing care than those who are white. In fact, according to the Centers for Disease Control and Prevention, a 20-year-old gay black man has a 50% chance of contracting HIV in his lifetime.
In a study published in the Journal of Acquired Immune Deficiency Syndrome
, the investigators sought to test the effects that bi-directional laboratory health information exchange (LHIE) intervention would have on ART and viral suppression.
Using a quasi-experimental, interrupted time-series design, the researchers examined whether the LHIE intervention improved ART use and viral suppression, as well as if it reduced racial/ethnic disparities in these outcomes among HIV-positive patients from a Southern California HIV/AIDS clinic.
The primary outcomes were ART pharmacy fill and HIV viral load laboratory data obtained from the medical records over 3 years. Race/ethnicity and an indicator for the intervention were the main predictors. The analysis was made up of a 3-stage, multivariable logistic regression with generalized estimating equations.
The results of the study showed that the intervention predicted greater odds of ART use and viral suppression in the final models, which included sociodemographic, behavioral, and clinical covariates.
At the start of the study, black patients used ART approximately 25% less frequently than white patients did and had 25% lower rates of viral suppression; however, the rates for both categories were equivalent by the end of the study.
Among Latino patients, use of ART and viral suppression were equivalent to white patients at the start of the study. After the LHIE interventions, levels were 77% and 33% greater, respectively.
Overall, viral suppression in black patients and Latino patients increased by 16% after implementation of the exchange.
“The intervention improved overall ART treatment and [viral suppression], and reduced black/white disparities,” the study authors conclude. “LHIE interventions may hold promise if implemented among similar patients.”
The Office of the National Coordinator for Health Information Technology reports that HIE allows physicians, nurses, pharmacists, patients, and other healthcare providers to appropriately access and securely share a patient’s vital medical information electronically to improve the speed, quality, safety and cost of patient care.
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