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  1. AU="Nicolette de Keizer"
  2. AU="Jamjoom, Dima"
  3. AU="Seeman, Tomas"
  4. AU="Popescu, S"
  5. AU="Kurtul, Irmak"
  6. AU="Christofferson, Scott"
  7. AU="Balghith, Mohammed A"
  8. AU="Banu, Qamar"
  9. AU="Giangregorio, Lora"
  10. AU="Stafiej, Patrycja"
  11. AU="Lau, Vincent W-H"
  12. AU="Francesca Storici"
  13. AU="Coulter-Mackie, Marion"
  14. AU="Mayank Goyal"
  15. AU="Lempke, Olga M"
  16. AU="Khan, Asad Majeed"
  17. AU=Ismail Mohd Iswadi
  18. AU="Jewel Park"
  19. AU="Hunter-Smith, David J"
  20. AU="Requião-Moura, Lúcio Roberto"
  21. AU=DesRochers Teresa M.
  22. AU="Kruschwitz, Sabine"
  23. AU=Sriwijiatalai Won
  24. AU="Bozzaro, Claudia"
  25. AU="Beckendorf, C"
  26. AU="Birge, N W"
  27. AU="Hoang, Oi Pui"
  28. AU="Saradha Baskaran"
  29. AU="Culotta, Lorenza"
  30. AU=Cleaver Ondine
  31. AU="Jordan A. Kreidberg"
  32. AU="Al-Marshoud, Majida"
  33. AU="David S Hui"
  34. AU="Manjappa, Shivaprasad"
  35. AU="Balkan, S"
  36. AU="Chen, Emma"
  37. AU="Delean, Ada"
  38. AU="Gurao, Ankita"
  39. AU="Lang, Zhen"
  40. AU="Mahnaz Mohammadpour"
  41. AU="Britta Grillitsch"
  42. AU=Hoeffner Ellen G
  43. AU="Al Harbi, Shmeylan"
  44. AU=Polevoda Bogdan
  45. AU="Raffaele Galiero"
  46. AU=Hruskova Z
  47. AU="Ayers, J"
  48. AU="Cohen, A D"
  49. AU="Brunetti, Gian Luca"
  50. AU=Andrade Daniel
  51. AU=Hay William W Jr

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  1. Artikel ; Online: A clinical decision support system is associated with reduced loss to follow-up among patients receiving HIV treatment in Kenya

    Tom Oluoch / Ronald Cornet / Jacques Muthusi / Abraham Katana / Davies Kimanga / Daniel Kwaro / Nicky Okeyo / Ameen Abu-Hanna / Nicolette de Keizer

    BMC Medical Informatics and Decision Making, Vol 21, Iss 1, Pp 1-

    a cluster randomized trial

    2021  Band 11

    Abstract: Abstract Background Loss to follow-up (LFTU) among HIV patients remains a major obstacle to achieving treatment goals with the risk of failure to achieve viral suppression and thereby increased HIV transmission. Although use of clinical decision support ... ...

    Abstract Abstract Background Loss to follow-up (LFTU) among HIV patients remains a major obstacle to achieving treatment goals with the risk of failure to achieve viral suppression and thereby increased HIV transmission. Although use of clinical decision support systems (CDSS) has been shown to improve adherence to HIV clinical guidance, to our knowledge, this is among the first studies conducted to show its effect on LTFU in low-resource settings. Methods We analyzed data from a cluster randomized controlled trial in adults and children (aged ≥ 18 months) who were receiving antiretroviral therapy at 20 HIV clinics in western Kenya between Sept 1, 2012 and Jan 31, 2014. Participating clinics were randomly assigned, via block randomization. Clinics in the control arm had electronic health records (EHR) only while the intervention arm had an EHR with CDSS. The study objectives were to assess the effects of a CDSS, implemented as alerts on an EHR system, on: (1) the proportion of patients that were LTFU, (2) LTFU patients traced and successfully linked back to treatment, and (3) time from enrollment on the study to documentation of LTFU. Results Among 5901 eligible patients receiving ART, 40.6% (n = 2396) were LTFU during the study period. CDSS was associated with lower LTFU among the patients (Adjusted Odds Ratio—aOR 0.70 (95% CI 0.65–0.77)). The proportions of patients linked back to treatment were 25.8% (95% CI 21.5–25.0) and 30.6% (95% CI 27.9–33.4)) in EHR only and EHR with CDSS sites respectively. CDSS was marginally associated with reduced time from enrollment on the study to first documentation of LTFU (adjusted Hazard Ratio—aHR 0.85 (95% CI 0.78–0.92)). Conclusion A CDSS can potentially improve quality of care through reduction and early detection of defaulting and LTFU among HIV patients and their re-engagement in care in a resource-limited country. Future research is needed on how CDSS can best be combined with other interventions to reduce LTFU. Trial registration NCT01634802. Registered at ...
    Schlagwörter Electronic medical records ; HIV ; Loss to follow-up ; Decision support systems ; Quality of care ; Low resource country ; Computer applications to medicine. Medical informatics ; R858-859.7
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2021-12-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  2. Artikel ; Online: Barriers and facilitators to the conduct of critical care research in low and lower-middle income countries

    Bharath Kumar Tirupakuzhi Vijayaraghavan / Ena Gupta / Nagarajan Ramakrishnan / Abi Beane / Rashan Haniffa / Nazir Lone / Nicolette de Keizer / Neill K J Adhikari

    PLoS ONE, Vol 17, Iss 5, p e

    A scoping review.

    2022  Band 0266836

    Abstract: Background Improvements in health-related outcomes for critically ill adults in low and lower-middle income countries need systematic investments in research capacity and infrastructure. High-quality research has been shown to strengthen health systems; ... ...

    Abstract Background Improvements in health-related outcomes for critically ill adults in low and lower-middle income countries need systematic investments in research capacity and infrastructure. High-quality research has been shown to strengthen health systems; yet, research contributions from these regions remain negligible or absent. We undertook a scoping review to describe barriers and facilitators for the conduct of critical care research. Methods We searched MEDLINE and EMBASE up to December 2021 using a strategy that combined keyword and controlled vocabulary terms. We included original studies that reported on barriers or facilitators to the conduct of critical care research in these settings. Two reviewers independently reviewed titles and abstracts, and where necessary, the full-text to select eligible studies. For each study, reviewers independently extracted data using a standardized data extraction form. Barriers and facilitators were classified along the lines of a previous review and based on additional themes that emerged. Study quality was assessed using appropriate tools. Results We identified 2693 citations, evaluated 49 studies and identified 6 for inclusion. Of the included studies, four were qualitative, one was a cross-sectional survey and one was reported as an 'analysis'. The total number of participants ranged from 20-100 and included physicians, nurses, allied healthcare workers and researchers. Barriers identified included limited funding, poor institutional & national investment, inadequate access to mentors, absence of training in research methods, limited research support staff, and absence of statistical support. Our review identified potential solutions such as developing a mentorship network, streamlining of regulatory processes, implementing a centralized institutional research agenda, developing a core-outcome dataset and enhancing access to low-cost technology. Conclusion Our scoping review highlights important barriers to the conduct of critical care research in low and ...
    Schlagwörter Medicine ; R ; Science ; Q
    Thema/Rubrik (Code) 306
    Sprache Englisch
    Erscheinungsdatum 2022-01-01T00:00:00Z
    Verlag Public Library of Science (PLoS)
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  3. Artikel ; Online: Variation in rates of ICU readmissions and post-ICU in-hospital mortality and their association with ICU discharge practices

    Nelleke van Sluisveld / Ferishta Bakhshi-Raiez / Nicolette de Keizer / Rebecca Holman / Gert Wester / Hub Wollersheim / Johannes G. van der Hoeven / Marieke Zegers

    BMC Health Services Research, Vol 17, Iss 1, Pp 1-

    2017  Band 9

    Abstract: Abstract Background Variation in intensive care unit (ICU) readmissions and in-hospital mortality after ICU discharge may indicate potential for improvement and could be explained by ICU discharge practices. Our objective was threefold: (1) describe ... ...

    Abstract Abstract Background Variation in intensive care unit (ICU) readmissions and in-hospital mortality after ICU discharge may indicate potential for improvement and could be explained by ICU discharge practices. Our objective was threefold: (1) describe variation in rates of ICU readmissions within 48 h and post-ICU in-hospital mortality, (2) describe ICU discharge practices in Dutch hospitals, and (3) study the association between rates of ICU readmissions within 48 h and post-ICU in-hospital mortality and ICU discharge practices. Methods We analysed data on 42,040 admissions to 82 (91.1%) Dutch ICUs in 2011 from the Dutch National Intensive Care Evaluation (NICE) registry to describe variation in standardized ICU readmission and post-ICU mortality rates using funnel-plots. We send a questionnaire to all Dutch ICUs. 75 ICUs responded and their questionnaire data could be linked to 38,498 admissions in the NICE registry. Generalized estimation equations analyses were used to study the association between ICU readmissions and post-ICU mortality rates and the identified discharge practices, i.e. (1) ICU discharge criteria; (2) bed managers; (3) early discharge planning; (4) step-down facilities; (5) medication reconciliation; (6) verbal and written handover; (7) monitoring of post-ICU patients; and (8) consulting ICU nurses. In all analyses, the outcomes were corrected for patient-related confounding factors. Results The standardized rate of ICU readmissions varied between 0.14 and 2.67 and 20.8% of the hospitals fell outside the 95% control limits and 3.6% outside the 99.8% control limits. The standardized rate of post-ICU mortality varied between 0.07 and 2.07 and 17.1% of the hospitals fell outside the 95% control limits and 4.9% outside the 99.8% control limits. We could not demonstrate an association between the eight ICU discharge practices and rates of ICU readmissions or post-ICU in-hospital mortality. Implementing a higher number of ICU discharge practices was also not associated with better patient outcomes. ...
    Schlagwörter Intensive care ; Critical care ; Variation ; Mortality ; Patient readmission ; Patient discharge ; Public aspects of medicine ; RA1-1270
    Thema/Rubrik (Code) 360
    Sprache Englisch
    Erscheinungsdatum 2017-04-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

    Volltext online

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