| HIV Clinical
Performance Measure: # 13 |
| Stated
Performance Measure: Percentage
of clients with HIV infection on antiretrovirals
who received adherence counseling at least
every 6 months |
| Numerator: |
Number
of clients with HIV infection who:
- received care from the grantee for
6 months or more, and
- were seen within the measurement
year, and
- are being treated with antiretrovirals,
and
- received adherence counseling during
appointments 6 months (or less) apart.[1]
|
| Denominator:
|
Number of
clients with HIV infection who:
- received care from the grantee for
6 months or more, and
- were seen within the measurement
year, and
- are being treated with antiretrovirals
|
| Data
Sources: |
- Electronic Medical Record/Electronic
Health Record
- CAREWare, Lab Tracker, or other electronic
data base.
- HIVQUAL reports on this measure for
grantee under review
- Medical record data abstraction by
grantee of a sample of records that
is negotiated with the OPR Review Team
|
| National Goals, Targets,
or Benchmarks for Comparison |
- IHI Goal: 90%[2]
- National HIVQUAL Performance Data:[3]
| |
2003 |
2004 |
2005 |
| Top
10% |
95.8% |
94.7%
|
97.5% |
| Top
25% |
82.7% |
84.1% |
88.3% |
| Median* |
64.0% |
56.8% |
60.8% |
*from HAB data base
|
| Basis
for Selection: |
“Adherence
is a key determinant in the degree and
duration of virologic suppression. Among
studies reporting on the association between
suboptimal adherence and virologic failure,
nonadherence among patients on HAART was
the strongest predictor for failure to
achieve viral suppression below the level
of detection. HIV viral suppression, reduced
rates of resistance, and improved survival
have been correlated with high rates of
adherence to antiretroviral therapy.
Prior to writing the first prescriptions,
clinicians need to assess the patient’s
readiness to take medication. Patients
need to understand that the first regimen
is the best chance for long-term success.
Resources need to be identified to assist
in success. Interventions can also assist
with identifying adherence education needs
and strategies for each patient. Examples
include adherence support groups, adherence
counselors, behavioral interventions,
using community-based case managers and
peer educators.”[4]
|
| US Public
Health Guidelines: |
| "...adherence
counseling and assessment should be done
at each clinical encounter"[5]
(10/10/06) |
| References/Notes: |
1 Adherence
counseling should begin prior to the initiation
of HAART, however it does not need to be
discussed and documented every 6 months
before HAART is initiated.
2
IHI Measure reads, “Percent of Patients/Clients
Assessed for Adherence to Antiretroviral
(ARV) Therapy in the Past 4 Months”
(http://www.ihi.org/IHI/Topics/HIVAIDS/HIVDiseaseGeneral/Measures/PercentofPatientsClientsAssessedforAdherencetoAntiretroviralARVTherapyinthePast4Months.htm)
3 (http://www.hivguidelines.org/admin/files/qoc/hivqual/proj%20info/HQNatlAggScrs3Yrs.pdf)
4 Guidelines
for the Use of Antiretroviral Agents in
HIV-1-Infected Adults and Adolescents
[April 7, 2005] (http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL04072005001.pdf)
5 Guidelines
for the Use of Antiretroviral Agents in
HIV-1-Infected Adults and Adolescents (http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf).
|
