title: Tuberculosis screening in patients with HIV: An audit against UK national guidelines to assess current practice and the effectiveness of an electronic tuberculosis-screening prompt.
abstract: A retrospective clinical audit was performed to assess if the British HIV Association 2011 guidelines on routine screening for tuberculosis in HIV are being implemented in a large UK urban clinic, and if a tuberculosis-screening prompt on the electronic patient record for new attendees was effective. Of 4658 patients attending during the inclusion period, 385 were newly diagnosed first-time attendees and routine tuberculosis screening was recommended in 165. Of these, only 6.1% of patients had a completed tuberculosis screening prompt, and 12.1% underwent routine tuberculosis screening. This audit represents the first published UK data on routine screening rates for tuberculosis in HIV and demonstrates low rates of tuberculosis screening despite an electronic screening prompt designed to simplify adherence to the national guideline. Reasons why tuberculosis screening rates were low, and the prompt ineffective, are unclear. A national audit is ongoing, and we await the results to see if our data reflect a lack of routine tuberculosis screening in HIV-infected patients at a national level.
authors.affiliation: Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK a.fox-lewis@nhs.net.
authors.forename: A
authors.initials: A
authors.lastname: Fox-Lewis
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Brima
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Muniina
authors.affiliation: Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Grant
authors.affiliation: Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK.
authors.forename: S G
authors.initials: SG
authors.lastname: Edwards
authors.affiliation: Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK Research Department of Infection and Population Health, University College London, London, UK Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: R F
authors.initials: RF
authors.lastname: Miller
authors.affiliation: Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK Research Department of Infection and Population Health, University College London, London, UK MRC Clinical Trials Unit at University College London, University College London, London, UK Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
authors.forename: S L
authors.initials: SL
authors.lastname: Pett
mesh_terms: D000328:Adult; D054869:Clinical Audit; D057286:Electronic Health Records; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology
keywords: HIV; Tuberculosis; audit; screening