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1994-10-25
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Document 2700
DOCN M94A2700
TI Improving compliance with guidelines for prevention of respiratory
disease within a cohort of gay men.
DT 9412
AU Zala C; Montaner JS; Phillips P; Craib KJ; Strathdee SA; Schechter MT;
O'Shaughnessy MV; BC Centre for Excellence in HIV/AIDS, NIIRDP,
Vancouver, Canada.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):244 (abstract no. PB0406). Unique
Identifier : AIDSLINE ICA10/94369875
AB OBJECTIVE: To assess the impact of feedback on the level of compliance
with guidelines for the prevention of specific respiratory diseases
within a cohort of gay men. METHODS: We identified HIV+ men in the
Vancouver Lymphadenopathy-AIDS Study cohort who completed 4 annual
visits during the period 10/89 to 12/93, and who were AIDS-free as of
12/93 (n = 154). HIV- men who completed visits during the same period
served as a comparison group (n = 169). Information about the use of
purified protein derivative testing (PPD); history of pneumoccocal
vaccinations (PV), influenza vaccinations (FV) and PCP prophylaxis
during the prior year was obtained for each subject. Data regarding CD4
counts were collected at the same time. Information regarding PV and FV
was available for the years 1992/93. Feed back information regarding the
level of compliance with the guidelines was provided to treating
physicians between 1992 and 1993. RESULTS: In the last 2 years
respectively, PPD testing was done in 51% and 65% of HIV+ subjects
compared to 21% and 40% of HIV- subjects. Although PPD was more
frequently used among HIV+ subjects in both years (p < .001), a
significant increase was present in both serologic groups (p < 0.01). In
the last 2 years respectively, PV was given to 23% and 67% of HIV+
subjects compared to less than 1% of HIV- subjects (p < 0.001). FV was
given to 78% and 92% of HIV+ subjects and 27% and 30% of HIV- subjects
(p < .001). In the last 2 years, primary PCP prophylaxis use increased
(p < 0.05) from 72% to 88% among subjects with CD4 < 200/mm3; from 52%
to 63% in those with CD4% < 20% and from 53% to 64% in subjects with
either CD4 < 200/mm3 or CD4% < 20%. CONCLUSION: Our data demonstrate a
significant increase in the level of compliance with guidelines for the
prevention of specific respiratory diseases within our cohort. This may
be due, in part, to feedback provided to treating physicians during this
interval. Compliance with guidelines may be much lower outside the
context of this cohort study which involves highly experienced treating
physicians.
DE AIDS-Related Opportunistic Infections/*PREVENTION & CONTROL British
Columbia Cohort Studies Feedback *Homosexuality Human Male
Pneumonia/ETIOLOGY/*PREVENTION & CONTROL Pneumonia, Pneumocystis
carinii/PREVENTION & CONTROL Pneumonia, Viral/PREVENTION & CONTROL
Practice Guidelines Risk Factors Tuberculosis, Pulmonary/PREVENTION &
CONTROL MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).