Evidence map›Paper›PMID 31577572›Full record

ArticleAIDS (London, England)2019

The association of provider and practice factors with HIV antiretroviral therapy adherence.

David J Meyers, Megan B Cole, Momotazur Rahman, Yoojin Lee, William Rogers, Roee Gutman, Ira B Wilson

Abstract read
In one paragraph

Article in AIDS (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

David J MeyersaDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island bDepartment of Health Law, Policy, & Management, Boston University School of Public Health cInstitute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts dDepartment of Biostatistics, Brown University School of Public Health, Providence, Rhode Island, USA.
Megan B Cole
Momotazur Rahman
Yoojin Lee
William Rogers
Roee Gutman
Ira B Wilson

Funding

Translational ScienceP30AI042853 · NIAID · MIRIAM HOSPITAL · PI LARRY K BROWN · 1998 to 2026
$51.7M
Tracking and Evaluation CoreU54GM115677 · NIGMS · BROWN UNIVERSITY · PI SCHMID, CHRISTOPHER H. · 2016 to 2025
$45.0M
Aging, comorbid conditions, and health care utilization in persons with HIVR01MH102202 · NIMH · BROWN UNIVERSITY · PI WILSON, IRA B · 2014 to 2017
$2.6M
Disparities in Nursing Home Care Quality for Patients Living with HIV/AIDSR01MH109394 · NIMH · BROWN UNIVERSITY · PI WILSON, IRA B · 2016 to 2019
$2.3M
NIAID NIH HHS P30 AI042853NIGMS NIH HHS U54 GM115677NIMH NIH HHS R01 MH102202NIMH NIH HHS R01 MH109394
6 · The paper itself

Abstract

objectiveWhile antiretroviral therapy (ART) is essential to patients with HIV, there is substantial variation in adherence nationally. We assess how provider and practice factors contribute to successful HIV ART adherence.

designWe used Medicaid Analytic Extract claims from 2008 to 2012. We attributed patients with HIV to the provider that provided the plurality of HIV-related services or primary care in a given year and assigned these providers to a medical practice based on the National Provider Identifier registry file. We fit successive linear hierarchical models with patient, provider, and practice characteristics to partition the variation in adherence driven by each factor. Our unit of analysis was the patient-year.

settingFourteen US states with the highest HIV prevalence.

participantsA total of 111 013 patient-years representing 60 496 Medicaid enrollees living with HIV attributed to 4930 providers and 1960 practices.

main outcome measurePercentage of year individual patients were adherent to an ART regimen.

resultsProvider and practice random effects jointly explained 6.8% of variation in adherence with patient differences accounted for 45.2% of the variation. Patients seen by generalists and other specialists had a 1.6 [95% confidence interval (CI): 0.6-2.5] and 5.1 (95% CI: 4.1-6.1) percentage point greater adherence than those seen by infectious disease specialists (P < 0.001). Every additional year a patient saw the same provider was associated with a 6% increase in adherence (95% CI: 5.7-6.3).

conclusionThere is substantial variation in ART adherence attributable to providers and practices and between provider specialties. To improve ART adherence for patients living with HIV, structural aspects of care should be considered.

Indexed as

Drug MonitoringAdolescentAdultAnti-HIV AgentsContinuity of Patient CareFemaleHealth Care CostsHIV InfectionsHumansInsurance Claim ReviewLinear ModelsMaleMedicaidMiddle AgedPrimary Health CareProfessional RoleAnti-HIV Agents

Identifiers

PMID31577572
PMCPMC6980422

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.