Missed visits and decline in CD4 cell count among HIV-infected patients: a mixed methods study
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 informati...
| Main Authors: | , , , , |
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| Format: | Journal Article |
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Elsevier Ltd
2012
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| Online Access: | http://hdl.handle.net/20.500.11937/9102 |
| _version_ | 1848745852085993472 |
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| author | Walburn, A. Swindells, S. Fisher, Christopher High, R. Islam, K. |
| author_facet | Walburn, A. Swindells, S. Fisher, Christopher High, R. Islam, K. |
| author_sort | Walburn, A. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T06:23:56Z |
| format | Journal Article |
| id | curtin-20.500.11937-9102 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T06:23:56Z |
| publishDate | 2012 |
| publisher | Elsevier Ltd |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-91022017-09-13T16:02:58Z Missed visits and decline in CD4 cell count among HIV-infected patients: a mixed methods study Walburn, A. Swindells, S. Fisher, Christopher High, R. Islam, K. 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. 2012 Journal Article http://hdl.handle.net/20.500.11937/9102 10.1016/j.ijid.2012.06.004 Elsevier Ltd unknown |
| spellingShingle | Walburn, A. Swindells, S. Fisher, Christopher High, R. Islam, K. Missed visits and decline in CD4 cell count among HIV-infected patients: a mixed methods study |
| title | Missed visits and decline in CD4 cell count among HIV-infected patients: a mixed methods study |
| title_full | Missed visits and decline in CD4 cell count among HIV-infected patients: a mixed methods study |
| title_fullStr | Missed visits and decline in CD4 cell count among HIV-infected patients: a mixed methods study |
| title_full_unstemmed | Missed visits and decline in CD4 cell count among HIV-infected patients: a mixed methods study |
| title_short | Missed visits and decline in CD4 cell count among HIV-infected patients: a mixed methods study |
| title_sort | missed visits and decline in cd4 cell count among hiv-infected patients: a mixed methods study |
| url | http://hdl.handle.net/20.500.11937/9102 |