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This cluster randomized control trial examines whether an audit and feedback study improves care of patients living with HIV/AIDS in a family health team setting.
This cluster randomized control trial will use electronic medical record (EMR) data from the St. Michael's Hospital Academic Family Health Team to examine whether the quality of HIV care provided to patients can be improved through an audit and feedback (A&F) intervention. Our objective is to examine whether A&F targeting family physicians caring for people living with HIV/AIDS (PHLA) using EMR data can improve laboratory monitoring, engagement in primary care and the uptake of preventive interventions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | Audit and feedback directed at family physicians, including reports a one-on-one meeting. |
|
| Control | No Intervention | Usual care; may receive the intervention at the end of the study if successful |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Audit and Feedback | Behavioral | Charts for enrolled physicians will be audited and they will receive feedback, consisting of tailored reports and one-on-one meeting with colleague to review at baseline, 3 months and 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Up to date viral load | Percentage of HIV infected patients who have an up to date HIV viral load | Within six months |
| Measure | Description | Time Frame |
|---|---|---|
| Clinic visit | To assess engagement in care (number of patients who went to see a physician) | Within the last 6 months |
| Up-to-date cancer screenings | Presence of cancer monitoring for colorectal, breast and cervical cancers |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Andrew Pinto, MSc MD | Unity Health Toronto | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St. Michael's Hospital | Toronto | Ontario | M5B1W8 | Canada |
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| ID | Term |
|---|---|
| D000163 | Acquired Immunodeficiency Syndrome |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
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| 1-3 years |
| Vaccinations | Up-to-date for both pneumococcal vaccines and seasonal influenza vaccine (number of patients who received a specific vaccination) | Since 2013 |
| Screening for diabetes | For those 40 or older, the presence of either a fasting blood glucose or HbA1c in the chart | Within 1 year |
| Screening for hypercholesterolemia | For those 40 or older. the presence of an LDL or non-HDL in the chart | Within 1 year |
| Screening for osteoporosis | For patients 50 years and older, the presence of a bone mineral density report | Within 5 years |
| D015229 |
| Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012897 | Slow Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |