| HIV Clinical
Performance Measure: # 15 |
| Stated
Performance Measure: Percentage
of clients with HIV infection who received
an oral health exam during the measurement
year |
| Numerator: |
Number
of clients with HIV infection who:
- were seen for a medical visit within
the measurement year, and
- had a dental exam during the measurement
year, based on patient self report or
other documentation[1]
|
| Denominator:
|
Number of
clients with HIV infection who were seen
for a medical visit within the measurement
year |
| Data
Sources: |
- CADR, Section 3, Item 33c may provide
data useful in establishing a baseline
for this performance measure[2]
- Electronic Medical Record/Electronic
Health Record
- CAREWare, Lab Tracker or other electronic
- 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: 75%[3]
- National HIVQUAL Data:[4]
| |
2003 |
2004 |
2005 |
| Top
10% |
100% |
100%
|
100% |
| Top
25% |
100% |
100% |
100% |
| Median* |
100% |
88.9% |
95.7 |
*from HAB data base
|
| Basis
for Selection: |
Oral
health care is an important component
of the management of patients with HIV
infection. A poorly functioning dentition
can adversely affect the quality of life,
complicate the management of medical conditions,
and create or exacerbate nutritional and
psychosocial problems.[5]
When the oral cavity is compromised by
the presence of pain or discomfort, maintaining
adherence to complicated antiretroviral
therapy regimens becomes more difficult.[6]
There is limited evidence on the risks
of oral procedures among persons with
HIV/AIDS. Evidence for the utility of
selected oral lesions as markers for seroconversion
is limited to a single study of a single
oral condition—candidiasis.[7]
In the later stages of HIV disease, greater
numbers of oral lesions and aggressive
periodontal breakdown are more likely;
therefore, oral health care visits should
be scheduled more frequently.[8]
|
| US Public
Health Guidelines: |
| Primary
health care providers should make an initial
dental referral for every HIV/AIDS patient
under their care. Oral health care providers
should examine all patients on a semiannual
basis for dental prophylaxis and other
appropriate preventive care. As HIV-related
medications may affect dental treatment
and cause adverse effects, the patient’s
oral health care provider should review
all medications being used by the patient
and should understand the potential for
these medications to affect oral health
care.[9] |
| References/Notes: |
1
A comprehensive
examination of hard and soft tissues in
the oral cavity provided by dentist. Not
a dental screening.
2
CADR does not provide number of
dental exams, preventive, curative treatments
and or surgeries. It only provides information
on the number of clients and number of visits
in the “Oral health care” service
category.
3
IHI Measure reads, “Percent
of Patients Receiving an Annual Dental Exam”
(http://www.ihi.org/IHI/Topics/HIVAIDS/HIVDiseaseGeneral/Measures/PercentofPatientsReceivinganAnnualDentalExam.htm)
4 ”Dental
Examination” (http://www.hivguidelines.org/admin/files/qoc/hivqual/proj%20info/HQNatlAggScrs3Yrs.pdf)
5 US DHHS
Oral Health in America: A Report of the
Surgeon General http://www2.nidcr.nih.gov/sgr/sgrohweb/welcome.htm
6 http://www.hivguidelines.org/public_html/center/clinical-guidelines/oral_care_guidelines/oral_health_book/oral_health_supp_pages/oral_health_chap1.htm#references
7
http://www.ahrq.gov/clinic/epcsums/denthivsum.htm
8 http://www.hivguidelines.org/public_html/center/clinical-guidelines/adult_hiv_guidelines/supplemental_pages/oral_health_adults/pdf/adults_oral_health.pdf
9 New
York State Dept of Health AIDS Institute
Oral Health Care for People With HIV Infection
http://www.hivguidelines.org/Content.aspx?pageID=263
|
