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T-Space at The University of Toronto Libraries >
Journal of Medical Internet Research >
Volume 9 (2007) >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/16630


Title: Information Systems for Patient Follow-Up and Chronic Management of HIV and Tuberculosis: A Life-Saving Technology in Resource-Poor Areas
Authors: Fraser, Hamish SF
Allen, Christian
Bailey, Christopher
Douglas, Gerry
Shin, Sonya
Blaya, Joaquin
Keywords: Review
Anti-retroviral therapy
developing countries
information systems
patient follow-up
HIV/AIDS
Tuberculosis
Issue Date: 22-Oct-2007
Publisher: Gunther Eysenbach; Centre for Global eHealth Innovation, Toronto, Canada
Citation: Hamish SF Fraser, Christian Allen, Christopher Bailey, Gerry Douglas, Sonya Shin, Joaquin Blaya. Information Systems for Patient Follow-Up and Chronic Management of HIV and Tuberculosis: A Life-Saving Technology in Resource-Poor Areas. J Med Internet Res 2007;9(4):e29 <URL: http://www.jmir.org/2007/4/e29/>
Abstract: [This item is a preserved copy and is not necessarily the most recent version. To view the current item, visit http://www.jmir.org/2007/4/e29/ ] Background: The scale-up of treatment for HIV and multidrug-resistant tuberculosis (MDR-TB) in developing countries requires a long-term relationship with the patient, accurate and accessible records of each patient’s history, and methods to track his/her progress. Recent studies have shown up to 24% loss to follow-up of HIV patients in Africa during treatment and many patients not being started on treatment at all. Some programs for prevention of maternal–child transmission have more than 80% loss to follow-up of babies born to HIV-positive mothers. These patients are at great risk of dying or developing drug resistance if their antiretroviral therapy is interrupted. Similar problems have been found in the scale-up of MDR-TB treatment. Objectives: The aim of the study was to assess the role of medical information systems in tracking patients with HIV or MDR-TB, ensuring they are promptly started on high quality care, and reducing loss to follow-up. Methods: A literature search was conducted starting from a previous review and using Medline and Google Scholar. Due to the nature of this work and the relative lack of published articles to date, the authors also relied on personal knowledge and experience of systems in use and their own assessments of systems. Results: Functionality for tracking patients and detecting those lost to follow-up is described in six HIV and MDR-TB treatment projects in Africa and Latin America. Preliminary data show benefits in tracking patients who have not been prescribed appropriate drugs, those who fail to return for follow-up, and those who do not have medications picked up for them by health care workers. There were also benefits seen in providing access to key laboratory data and in using this data to improve the timeliness and quality of care. Follow-up was typically achieved by a combination of reports from information systems along with teams of community health care workers. New technologies such as low-cost satellite Internet access, personal digital assistants, and cell phones are helping to expand the reach of these systems. Conclusions: Effective information systems in developing countries are a recent innovation but will need to play an increasing role in supporting and monitoring HIV and MDR-TB projects as they scale up from thousands to hundreds of thousands of patients. A particular focus should be placed on tracking patients from initial diagnosis to initiation of effective treatment and then monitoring them for treatment breaks or loss to follow-up. More quantitative evaluations need to be performed on the impact of electronic information systems on tracking patients.
Description: Reviewer: Mark, Linda
Reviewer: Pourmalek, Farshad
URI: http://dx.doi.org/ 10.2196/jmir.9.4.e29
http://hdl.handle.net/1807/16630
ISSN: 1438-8871
Rights: © Hamish SF Fraser, Christian Allen, Christopher Bailey, Gerry Douglas, Sonya Shin, Joaquin Blaya. Originally published in the Journal of Medical Internet Research (http://www.jmir.org, 22.10.2007). Except where otherwise noted, articles published in the Journal of Medical Internet Research are distributed under the terms of the Creative Commons Attribution License (http://www.creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited, including full bibliographic details and the URL (see "please cite as" above), and this statement is included.
Appears in Collections:Volume 9 (2007)

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