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    Missed visits and decline in CD4 cell count among HIV-infected patients: a mixed methods study

    Access Status
    Open access via publisher
    Authors
    Walburn, A.
    Swindells, S.
    Fisher, Christopher
    High, R.
    Islam, K.
    Date
    2012
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Walburn, A. and Swindells, S. and Fisher, C. and High, R. and Islam, K. 2012. Missed visits and decline in CD4 cell count among HIV-infected patients: a mixed methods study. International Journal of Infectious Diseases. 16 (11): pp. e779-e785.
    Source Title
    International Journal of Infectious Diseases
    DOI
    10.1016/j.ijid.2012.06.004
    ISSN
    1878-3511
    School
    Department of Health Promotion and Sexology
    URI
    http://hdl.handle.net/20.500.11937/9102
    Collection
    • Curtin Research Publications
    Abstract

    Objective: To determine the impact of missed visits on CD4 cell count with HIV disease in a Midwest clinic. Methods: This was a mixed method study consisting of a quantitative retrospective cohort study of missed clinic visits among HIV-infected patients, and a qualitative study to collect information on factors impacting appointment attendance. A drop in CD4 cell count greater than 50 cells/mm3 from baseline was the primary outcome variable for the quantitative study. The exposure variable was missed visits. Results: Of 77 patients, 16.4% experienced the outcome of interest. Lower visit proportions increased the risk of a CD4 drop (hazard ratio 0.0188, 95% confidence interval 0.001–0.292). For each 10% increase in the missed visit proportion, the risk of a CD4 drop of >50 cells/mm3 from baseline increased by 33%. Qualitative data suggested that stigma, external support, and physician–patient interactions impacted engagement in care. Conclusion: These results may help providers increase patient motivation and ability to attend clinic appointments.

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