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).