Catálogo general VIH/sida
HIV indicator diseases in primary care: experience in the Community of Madrid (Project ESTVIH)
Resumen
Background and objectives: In the framework of the project ESTVIH of 'Assessment of strategies to promote early diagnosis of HIV in Primary Care', one of the strategies promotes the diagnosis of HIV infection in people with indicator disease (ID). The objectives were to describe the experience of implementation of this strategy and to analyze the most frequent episodes of ID. Methods: Multicenter study in 10 primary health care centers in the Community of Madrid, randomly selected from areas with high incidence of HIV infection. Period of study: 12 months. The strategy promotes HIV test in patients 18-64 years old with ID. We considered ID according European recommendations and selected them by The International Classification of Primary Care (ICPC) codes. At baseline (September 2015) we selected the ID episodes in the last 24 months of patients assigned to study centers and subsequently three quarterly updates were made. In the electronic clinical records of these patients a reminder was implemented: "There is indicator disease for HIV testing if it has not previously done". Also a HIV-protocol was implemented to record the assessment and performance of HIV testing. A descriptive analysis of the most frequent diseases was performed. Results: We selected 46 ICPC codes corresponding to ID. We considered 22,840 episodes, in 15,776 patients. The most common events with incorporated reminders were: candidiasis (ICPC: X72, Y75, S75) 26.5%, herpes zoster (ICPC: S70) 9.9%, seborrheic dermatitis (ICPC: S86) 9.7%, lymphadenopathy (ICPC: B02) 7.8%, cervical dysplasia (ICPC: X86, X85, X75) 7.2% and unexplained weight loss (ICPC: T08) 6.2%. The indication of the test was assessed in 1,749 patients and in 792 patients the HIV test was requested. The most frequent ID in these patients were: candidiasis 27.4%, herpes zoster 14.7%, seborrheic dermatitis 11.6%, sexually transmitted infections 11% and cervical dysplasia 4.8%. The main reasons for not testing were: non-specific reminder (58.2%) and previous serology after diagnosis of IE (27.8%). Five new diagnoses of HIV infection were made (patients with herpes zoster, seborrheic dermatitis, prolonged diarrhea, unexplained weight loss and fever without apparent cause, respectly). Conclusions: Patients with HIV indicator diseases are frequently attended in primary care. The implementation of reminders in the electronic clinical record contributes to the identification of patients with these diseases but to make the process more efficient it is necessary to adapt the list according to the frequency of the disease and the specificity of the code.- Tema:
Autoría:
PICHIULE CASTAÑEDA, Myrian; ESTEBAN VASALLO, María Dolores; DOMÍNGUEZ BERJÓN, Felícitas; RUIZ ALONSO, Sergio; ARENAS GONZÁLEZ, Sonia; PÉREZ GANDÍA, Olga María; SÁNCHEZ LOZANO, Sandra; CASTELLANOS MARTÍNEZ, Francisco Javier; EPIFANIO GUTIÉRREZ, María Del Mar; FERRUELO MAGÁN, Manuela; LORENZO ANDRÉS, María Rivera; GONZÁLEZ TEJADA, Ricardo; DURÁN TEJADA, María Rosa; FERNÁNDEZ GÓMEZ, Patricia; CEVALLOS GARCÍA, Carlos; GARCÍA RIOLOBOS, Carmen; MORÁN ARRIBAS, Mónica; ÁLVAREZ CASTILLO, María del Carmen; ASTRAY MOCHALES, Jenaro
Autoría institucional: Grupo ESTVIH (Estrategia de Diagnóstico Precoz de VIH en Atención Primaria)
Autoría institucional: Grupo ESTVIH (Estrategia de Diagnóstico Precoz de VIH en Atención Primaria)
Ficha bibliográfica
- Año de publicación:
- [2016]
- Descripción física:
- [1] p.
- Formato:
- Folleto
- Tipo de documento:
- Coloquios y ponencias
- Notas:
- Póster presentado en el VIII Congreso Nacional Gesida y 10ª Reunión Docente de la Red de Investigación en Sida celebrado del 29 de noviembre al 2 de diciembre de 2016 en San Sebastián.