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

Anna Walburn, Susan Swindells, Christopher Fisher, Robin High, K. M. Islam

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)e779-e785
JournalInternational Journal of Infectious Diseases
Volume16
Issue number11
DOIs
StatePublished - Nov 1 2012

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CD4 Lymphocyte Count
HIV
Appointments and Schedules
Ambulatory Care
Cohort Studies
Retrospective Studies
Confidence Intervals
Physicians

Keywords

  • CD4 count
  • HIV infection
  • Missed visits

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Missed visits and decline in CD4 cell count among HIV-infected patients : A mixed method study. / Walburn, Anna; Swindells, Susan; Fisher, Christopher; High, Robin; Islam, K. M.

In: International Journal of Infectious Diseases, Vol. 16, No. 11, 01.11.2012, p. e779-e785.

Research output: Contribution to journalArticle

Walburn, Anna ; Swindells, Susan ; Fisher, Christopher ; High, Robin ; Islam, K. M. / Missed visits and decline in CD4 cell count among HIV-infected patients : A mixed method study. In: International Journal of Infectious Diseases. 2012 ; Vol. 16, No. 11. pp. e779-e785.
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