scholarly journals Linkage-to-care Methods and Rates in U.S. Emergency Department-based HIV Testing Programs: A Systematic Literature Review Brief Report

2016 ◽  
Vol 23 (7) ◽  
pp. 835-842 ◽  
Author(s):  
Aravind A. Menon ◽  
Carolyn Nganga-Good ◽  
Mikeeo Martis ◽  
Cassie Wicken ◽  
Katie Lobner ◽  
...  
Keyword(s):  
Emergency Department ◽  
Literature Review ◽  
Hiv Testing ◽  
Systematic Literature Review ◽  
Linkage To Care

Routine HIV Screening in Cancer Patients in the Emergency Department

2018 ◽  
Vol 17 (2) ◽  
pp. 91-95
Author(s):  
Terry W Rice ◽  
◽  
Patricia A. Brock ◽  
Carmen Gonzalez ◽  
Kelly W Merriman ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hiv Testing ◽  
Cancer Patients ◽  
Linkage To Care ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Hiv Screening ◽  
Immunodeficiency Virus ◽  
Routine Hiv Screening ◽  
Incident Cases

Treatment of human immunodeficiency virus(HIV) in cancer patients improves outcomes and reduces transmission of this oncogenic virus. HIV testing rates of cancer patients are similar to the general population (15-40%), despite the association with cancer. Our aim was to increase HIV screening in the Emergency Department(ED) of a comprehensive cancer center through a quality initiative. Testing increased significantly during the intervention (p<0.001; 0.15/day to 2.69/day). Seropositive HIV rate was 1.4% (12/852), with incidence of 0.3%. All patients were linked to care. Incident cases were between 36 and 55 years of age. Barriers encountered included confusion regarding the need for written consent for HIV testing, failure to consider ordering the test, and concerns regarding linkage to care.

scholarly journals A systematic review of emergency department based HIV testing and linkage to care initiatives in low resource settings

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0187443 ◽  
Author(s):  
Bhakti Hansoti ◽  
Gabor D. Kelen ◽  
Thomas C. Quinn ◽  
Madeleine M. Whalen ◽  
Taylor T DesRosiers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Hiv Testing ◽  
Linkage To Care ◽  
Low Resource Settings ◽  
Low Resource

scholarly journals HIV Testing and Counseling Among Female Sex Workers: A Systematic Literature Review

2018 ◽  
Vol 22 (8) ◽  
pp. 2435-2457 ◽  
Author(s):  
Anna Tokar ◽  
Jacqueline E. W. Broerse ◽  
James Blanchard ◽  
Maria Roura
Keyword(s):  
Literature Review ◽  
Hiv Testing ◽  
Systematic Literature Review ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Female Sex ◽  
Hiv Testing And Counseling ◽  
Testing And Counseling

scholarly journals Impact of Patient Navigators in Linkage to Care for HIV-Positive Patients in an Urban Emergency Department in Newark, NJ

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S420-S420
Author(s):  
Samuel Maldonado ◽  
Gregory Sugalski ◽  
Garry Closeil ◽  
Shobha Swaminathan
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Hiv Testing ◽  
Hiv Risk ◽  
Linkage To Care ◽  
Patient Navigators ◽  
Hiv Test ◽  
Routine Hiv Testing ◽  
The Impact ◽  
White Patients

Abstract Background Despite CDC recommendations, areas with high HIV prevalence have not implemented routine HIV testing, stating among other concerns, inability to effectively link them to care. We implemented a routine HIV testing program in the Emergency Department (ED) at University Hospital in Newark, NJ that had 46,164 visits from July 2015 to November 2016 and looked at the impact of patient navigators (PN) on linkage to care (LTC) rates. Methods This was a retrospective study of all patients newly diagnosed (ND) with HIV or previously positive (PP) but lost to follow-up (LTFU) in select areas of the ED from July 2015 to November 2016. We collected information on demographics, HIV risk factor, and looked at the impact of PN on LTC by comparing months the PN was able to make personal contact compared with months when the PN was unavailable for substantial periods of time. Results A total of 9,511 individuals were screened, and 151 (1.6%) had a positive HIV test; 8 died and 2 were incarcerated. Of the remaining 141, 102 (72%) were LTC. The mean age was 49, 57% Male, 77% Black, 14% Hispanic, and 6% White. The reported HIV risk factors were 67% Heterosexual, 9% MSM, 6% IV drug use (IDU) and 18% Other. Of the patients with a positive HIV test, 60 (43%) were ND and 81 (57%) were PP. Only 52% ND patients were LTC, while 88% PP patients were LTC. Black and Hispanic patients tended to be PP (60% of both groups), while White patients tended to be ND (75% of white patients were ND). The risk factors for ND were 44% Heterosexual, 39% MSM, and 25% IDU. Average LTC while the PN was unavailable decreased from 78% to 56%. There were no demographic differences in the LTC group compared with the LTFU group. IDU had the highest rate of being LTFU at 37% followed by MSM and Heterosexual at approximately 23% each. The primary reason for LTFU was incorrect contact information in the medical record such as wrong address or phone number. PN would make 3 phone calls, send 2 letters and 1 outreach attempt. If all of those failed, the PN notified the state health department. Conclusion PN have a positive impact on LTC even in busy ED settings. Given limitations of staffing a busy ED 24/7, we need to develop strategies to link patients even if the PN is not present. To address this limitation, we plan on looking at the impact of involving medical residents to help with linkage to care after business hours. Disclosures S. Swaminathan, Gilead Sciences: Grant Investigator and Scientific Advisor, Consulting fee and Research grant

scholarly journals Systematic literature review of emergency department physicians’ confidence to treat dental pain and the frequency with which they prescribe pain medications: Considerations for improved outcomes.

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Sara Barna ◽  
Jean O'Donnell ◽  
Marnie Oakley
Keyword(s):  
Emergency Department ◽  
Drug Abuse ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Emergency Departments ◽  
Dental Pain ◽  
Dental Patients ◽  
Pain Medications ◽  
Prescribing Trends ◽  
Pain Patients

Opioid analgesics, when taken as prescribed, are effective therapeutic options that provide pain relief for moderate to severe pain. The use of opioids in the treatment of pain has been increasing in the U.S. at an alarming rate, possibly contributing to the simultaneous rise in opioid abuse. Emergency departments play a major role in managing patients who present in pain, with approximately 10% of all opioid analgesic prescriptions written in hospital emergency departments. It is estimated that dental pain patients represent between 0.3-4% of the overall patient emergency department workload. Yet, the literature suggests that many of these physicians may not have sufficient training in handling dentofacial emergencies. The goal of this study was to systematically review the available literature on the topics of: 1) emergency department physicians’ training related to treating dental pain patients, and 2) the frequency in which they prescribe opioid medications to these patients. Methods: A systematic literature review was conducted among publications from 1985-2014 in the databases PubMed, Ovid, and Science Citation Index. The following search terms were used in this systematic literature review in order to identify the available literature of interest: “opioid and dental and emergency departments,” “dental pain and drug abuse,” “ER physicians and dental pain,” “ER physicians and drug abuse,” and “dental pain and emergency departments.” Publications in any language or country were considered, as well as editorials and commentaries. Findings: A total of 769 publications were identified. Seventeen publications met the criteria for inclusion. Eight studies commented on the emergency department physicians’ perceived “lack of training” in handling dentofacial emergencies and found that the majority of this group did not feel comfortable in managing dental patients. Nine studies assessed the frequency in which physicians prescribe pain medications to dental patients. Within these 9 studies, 5 specifically reported that between 29.6% and 81% of dental patients treated, received an “opioid” or a “narcotic” upon discharge. The remaining 4 studies in this group instead used non-specific terms that included “prescription medications,” “analgesics,” “pain medicine,” and “pharmacotherapy” to describe their findings and did not particularly report opioid prescribing trends. Of those publications rejected, 9 addressed the topic of dental pain patients presenting to non-dental providers, but did not include data that met the criteria related to emergency department prescribing frequency or physician training. Conclusions: This review of the literature suggests that emergency department physicians’ training level in treating dentofacial pain is less than ideal. It also confirms that individuals presenting to emergency departments with dental pain are a subset of the population of patients who are prescribed opioids as an analgesic. Coupling these results with the increased use of opioids in this country, dentists are in a key position to collaborate with emergency department physicians to help positively affect change. To further justify this approach, research agendas must carefully monitor prescribing patterns for dentofacial pain in the emergency department that are specific to opioid use, carefully excluding other non-narcotic analgesics. Should comparable outcomes of data related to the same topic in other non-dental settings exist, additional areas in medicine that may benefit from this partnership may also be identified. Moving forward, this interprofessional team approach may include a presence in medical school and residency program curricula so that alternative treatment options for addressing dental pain patients can be presented that consider the increased prescribing trends of opioids.

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