Clinical Decision-support Reminders to Improve IPT Initiation Among HIV Positive Adults in Western Kenya

Does Providing Medical Personnel in the AMPATH Network With Patient-specific Reminders Regarding TB That Are Generated From a Patient's EMR Improve the Prevalence of IPT Initiation and Decrease the Time From Screening to Treatment?

The overall research objective is to evaluate the impact of implementing a reminder system for medical providers to improve TB case-finding and isoniazid preventative therapy (IPT) for adults living with HIV in western Kenya

The purpose of this study is to evaluate the impact of implementing a clinical decision support reminder system for medical providers (i.e., nurses, clinical officers, medical officers, consultants) to improve tuberculosis case-finding and the use of isoniazid preventative therapy for adults living with HIV in western Kenya.

Clusters:

Inclusion Criteria

• active
• uses HIV initial and return encounter paper forms
• enters data into the AMPATH medical records system (AMRS) or sends forms to central location for data entry
• prints or receives printed paper summary sheets with reminders
• interprets chest x-rays
• interprets sputum smear results
• prescribes IPT and dispenses INH
• completed an average of 10 initial adult HIV positive encounters per month in 2012
• HIV Care Clinic

Exclusion Criteria -

Patients:

Inclusion Criteria

• HIV positive
• complete an adult initial encounter at an HIV Care Clinic during the enrollment period
• attend at least one additional appointment within 90 days after the initial encounter

Exclusion Criteria

- history of TB or IPT