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Appenheimer AB, Bokhour B, McInnes DK, et al. Should Human Immunodeficiency Virus Specialty Clinics Treat Patients With Hypertension or Refer to Primary Care? An Analysis of Treatment Outcomes. Open Forum Infect Dis. 2017;4(1):ofx005doi: 10.1093/ofid/ofx005.
Appenheimer, A. B., Bokhour, B., McInnes, D. K., Richardson, K. K., Thurman, A. L., Beck, B. F., Vaughan-Sarrazin, M., Asch, S. M., Midboe, A. M., Taylor, T., Dvorin, K., Gifford, A. L., & Ohl, M. E. (2017). Should Human Immunodeficiency Virus Specialty Clinics Treat Patients With Hypertension or Refer to Primary Care? An Analysis of Treatment Outcomes. Open forum infectious diseases, 4(1), ofx005. https://doi.org/10.1093/ofid/ofx005
Appenheimer, A Ben, et al. "Should Human Immunodeficiency Virus Specialty Clinics Treat Patients With Hypertension or Refer to Primary Care? An Analysis of Treatment Outcomes." Open forum infectious diseases vol. 4,1 (2017): ofx005. doi: https://doi.org/10.1093/ofid/ofx005
Appenheimer AB, Bokhour B, McInnes DK, Richardson KK, Thurman AL, Beck BF, Vaughan-Sarrazin M, Asch SM, Midboe AM, Taylor T, Dvorin K, Gifford AL, Ohl ME. Should Human Immunodeficiency Virus Specialty Clinics Treat Patients With Hypertension or Refer to Primary Care? An Analysis of Treatment Outcomes. Open Forum Infect Dis. 2017 Feb 03;4(1):ofx005. doi: 10.1093/ofid/ofx005. eCollection 2017. PMID: 28480278; PMCID: PMC5413997.
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Open Forum Infect Dis. 2017 Feb 03;4(1):ofx005. doi: 10.1093/ofid/ofx005. eCollection 2017.

Should Human Immunodeficiency Virus Specialty Clinics Treat Patients With Hypertension or Refer to Primary Care? An Analysis of Treatment Outcomes.

Open forum infectious diseases

A Ben Appenheimer, Barbara Bokhour, D Keith McInnes, Kelly K Richardson, Andrew L Thurman, Brice F Beck, Mary Vaughan-Sarrazin, Steven M Asch, Amanda M Midboe, Thom Taylor, Kelly Dvorin, Allen L Gifford, Michael E Ohl

Affiliations

  1. Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City VA Medical Center, Iowa.
  2. Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City.
  3. Boston University School of Public Health, Department of Health Law, Policy, and Management, Massachusetts.
  4. Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial VA Healthcare System, Bedford, Massachusetts.
  5. Division of General Medical Science, Department of Medicine, Stanford University School of Medicine, Palo Alto, California.
  6. Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California.

PMID: 28480278 PMCID: PMC5413997 DOI: 10.1093/ofid/ofx005

Abstract

BACKGROUND: Care for people with human immunodeficiency virus (HIV) increasingly focuses on comorbidities, including hypertension. Evidence indicates that antiretroviral therapy and opportunistic infections are best managed by providers experienced in HIV medicine, but it is unclear how to structure comorbidity care. Approaches include providing comorbidity care in HIV clinics ("consolidated care") or combining HIV care with comorbidity management in primary care clinics ("shared care"). We compared blood pressure (BP) control in HIV clinics practicing consolidated care versus shared care.

METHODS: We created a national cohort of Veterans with HIV and hypertension receiving care in HIV clinics in Veterans Administration facilities and merged these data with a survey asking HIV providers how they delivered hypertension care (5794 Veterans in 73 clinics). We defined BP control as BP ≤140/90 mmHg on the most recent measure. We compared patients' likelihood of experiencing BP control in clinics offering consolidated versus shared care, adjusting for patient and clinic characteristics.

RESULTS: Forty-two of 73 clinics (57.5%) practiced consolidated care for hypertension. These clinics were larger and more likely to use multidisciplinary teams. The unadjusted frequency of BP control was 65.6% in consolidated care clinics vs 59.4% in shared care clinics (

CONCLUSIONS: Patients were more likely to experience BP control in clinics reporting consolidated care compared with clinics reporting shared care. For shared-care clinics, improving care coordination between HIV and primary care clinics may improve outcomes.

Published by Oxford University Press on behalf of Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Keywords: HIV; Veterans.; hypertension; shared care

References

  1. Clin Infect Dis. 2005 Sep 1;41(5):738-43 - PubMed
  2. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004910 - PubMed
  3. Med Care. 2005 Jan;43(1):12-20 - PubMed
  4. Int J STD AIDS. 2015 Dec;26(14):991-7 - PubMed
  5. Med Care. 2009 May;47(5):560-7 - PubMed
  6. Clin Infect Dis. 2014 Oct 15;59(8):1160-7 - PubMed
  7. Ann Intern Med. 2010 Feb 16;152(4):247-58 - PubMed
  8. Med Care. 2006 Aug;44(8 Suppl 2):S25-30 - PubMed
  9. J Gen Intern Med. 2014 Jul;29 Suppl 2:S695-702 - PubMed
  10. Clin Infect Dis. 2007 Jun 15;44(12):1625-31 - PubMed
  11. J Acquir Immune Defic Syndr. 2000 Jun 1;24(2):106-14 - PubMed
  12. Open Forum Infect Dis. 2017 Jan 31;4(1):ofw240 - PubMed
  13. J Gen Intern Med. 2009 Mar;24(3):334-40 - PubMed
  14. Am J Manag Care. 2008 Apr;14(4):213-24 - PubMed
  15. J Rural Health. 2014 Fall;30(4):412-21 - PubMed
  16. J Clin Endocrinol Metab. 2007 Jul;92(7):2506-12 - PubMed
  17. AIDS Patient Care STDS. 2006 May;20(5):318-25 - PubMed
  18. JAMA. 2013 Apr 3;309(13):1397-405 - PubMed
  19. AIDS Care. 2016;28(4):475-82 - PubMed
  20. BMJ Open. 2015 May 13;5(5):e007428 - PubMed
  21. Clin Infect Dis. 2011 Dec;53(11):1043-50 - PubMed
  22. Cochrane Database Syst Rev. 2006 Jul 19;(3):CD004348 - PubMed
  23. J Urban Health. 2011 Jun;88(3):556-66 - PubMed
  24. Mil Med. 2005 Nov;170(11):952-9 - PubMed

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