|'Connect Email': 4 Years Experience of an Email Clinic in an Outpatient HIV Setting||
|J. Whetham1, C. Hendrickx1, M. Fisher1|
|1Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom|
|Objectives: In September 2008 we set up an email service whereby stable HIV positive individuals see their physician annually but have results of interim monitoring bloods emailed to them. We describe our experience to date.|
Methods: Patients are invited to join Connect email if they are: HIV positive > 1 year; on combination antiretroviral therapy (cART) with last two HIV viral loads (VL) undetectable or cART naïve with CD4 >500; have no active medical/ mental health problem requiring HIV team input. Informed consent is received from individuals. Patients may contact the clinic at any time; if increased clinical input needed the email service is 'paused' until problem resolved. All results are checked by a clinician before results emailed/ cART dispensed via home delivery. Data is collected prospectively.
Results: 32.9% of current cohort (674/2050) have registered with Connect email since 2008: 613/674 (90.9%) male; 593/674 (87.9%) Caucasian; 561/674 (83.2%) MSM; median age 47 (range 22-81); median CD4 585 (IQR 442-767); 632/674 (92.7%) on ARVs with 612/632 (96.8%) undetectable VL; median 10.5 years since HIV diagnosis (range 1.2-29.5).
524 are currently using Connect email: 483 (92.7%) on ARVs, all with undetectable VLs.
33/674 (4.9%) stopped using the service (2 moved area, 10 found 6 monthly appointments easier, 2 home delivery problem, 7 missed clinician contact; 2 computer problem; other 10).
117 patients are currently 'paused': 60 for medical reasons (including 7 with acute Hep C); 26 on research studies; 26 to start/switch ARVs; 5 with detectable HIV VL being assessed.
Conclusions: High uptake of Connect email has helped us manage capacity in our busy HIV outpatient service, freeing-up more than 800 physician appointments per year. Low dropout rates support patient feedback showing good acceptability of the service. Outpatient HIV services should consider email clinics as an option for stable patients.
Jennifer Whetham , Brighton and Sussex University Hospitals NHS Trust , Brighton , United Kingdom
Assigned in sessions:
18.10.2013, 10:30-12:30, Parallel Session, PS8, Retention in Care / Strategies for HIV Testing, Copper Hall