Reducing communication delays and improving quality of care with a tuberculosis laboratory information system in resource poor environments: a cluster randomized controlled trial.
<h4>Background</h4>Lost, delayed or incorrect laboratory results are associated with delays in initiating treatment. Delays in treatment for Multi-Drug Resistant Tuberculosis (MDR-TB) can worsen patient outcomes and increase transmission. The objective of this study was to evaluate the i...
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0090110 |
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| author | Joaquín A Blaya Sonya S Shin Martin Yagui Carmen Contreras Peter Cegielski Gloria Yale Carmen Suarez Luis Asencios Jaime Bayona Jihoon Kim Hamish S F Fraser |
| author_facet | Joaquín A Blaya Sonya S Shin Martin Yagui Carmen Contreras Peter Cegielski Gloria Yale Carmen Suarez Luis Asencios Jaime Bayona Jihoon Kim Hamish S F Fraser |
| author_sort | Joaquín A Blaya |
| collection | DOAJ |
| description | <h4>Background</h4>Lost, delayed or incorrect laboratory results are associated with delays in initiating treatment. Delays in treatment for Multi-Drug Resistant Tuberculosis (MDR-TB) can worsen patient outcomes and increase transmission. The objective of this study was to evaluate the impact of a laboratory information system in reducing delays and the time for MDR-TB patients to culture convert (stop transmitting).<h4>Methods</h4><h4>Setting</h4>78 primary Health Centers (HCs) in Lima, Peru. Participants lived within the catchment area of participating HCs and had at least one MDR-TB risk factor. The study design was a cluster randomized controlled trial with baseline data. The intervention was the e-Chasqui web-based laboratory information system. Main outcome measures were: times to communicate a result; to start or change a patient's treatment; and for that patient to culture convert.<h4>Results</h4>1671 patients were enrolled. Intervention HCs took significantly less time to receive drug susceptibility test (DST) (median 11 vs. 17 days, Hazard Ratio 0.67 [0.62-0.72]) and culture (5 vs. 8 days, 0.68 [0.65-0.72]) results. The time to treatment was not significantly different, but patients in intervention HCs took 16 days (20%) less time to culture convert (p = 0.047).<h4>Conclusions</h4>The eChasqui system reduced the time to communicate results between laboratories and HCs and time to culture conversion. It is now used in over 259 HCs covering 4.1 million people. This is the first randomized controlled trial of a laboratory information system in a developing country for any disease and the only study worldwide to show clinical impact of such a system.<h4>Trial registration</h4>ClinicalTrials.gov NCT01201941. |
| format | Article |
| id | doaj-art-5223a54837c7415c8a444a9e740cd017 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-5223a54837c7415c8a444a9e740cd0172025-08-20T03:46:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0194e9011010.1371/journal.pone.0090110Reducing communication delays and improving quality of care with a tuberculosis laboratory information system in resource poor environments: a cluster randomized controlled trial.Joaquín A BlayaSonya S ShinMartin YaguiCarmen ContrerasPeter CegielskiGloria YaleCarmen SuarezLuis AsenciosJaime BayonaJihoon KimHamish S F Fraser<h4>Background</h4>Lost, delayed or incorrect laboratory results are associated with delays in initiating treatment. Delays in treatment for Multi-Drug Resistant Tuberculosis (MDR-TB) can worsen patient outcomes and increase transmission. The objective of this study was to evaluate the impact of a laboratory information system in reducing delays and the time for MDR-TB patients to culture convert (stop transmitting).<h4>Methods</h4><h4>Setting</h4>78 primary Health Centers (HCs) in Lima, Peru. Participants lived within the catchment area of participating HCs and had at least one MDR-TB risk factor. The study design was a cluster randomized controlled trial with baseline data. The intervention was the e-Chasqui web-based laboratory information system. Main outcome measures were: times to communicate a result; to start or change a patient's treatment; and for that patient to culture convert.<h4>Results</h4>1671 patients were enrolled. Intervention HCs took significantly less time to receive drug susceptibility test (DST) (median 11 vs. 17 days, Hazard Ratio 0.67 [0.62-0.72]) and culture (5 vs. 8 days, 0.68 [0.65-0.72]) results. The time to treatment was not significantly different, but patients in intervention HCs took 16 days (20%) less time to culture convert (p = 0.047).<h4>Conclusions</h4>The eChasqui system reduced the time to communicate results between laboratories and HCs and time to culture conversion. It is now used in over 259 HCs covering 4.1 million people. This is the first randomized controlled trial of a laboratory information system in a developing country for any disease and the only study worldwide to show clinical impact of such a system.<h4>Trial registration</h4>ClinicalTrials.gov NCT01201941.https://doi.org/10.1371/journal.pone.0090110 |
| spellingShingle | Joaquín A Blaya Sonya S Shin Martin Yagui Carmen Contreras Peter Cegielski Gloria Yale Carmen Suarez Luis Asencios Jaime Bayona Jihoon Kim Hamish S F Fraser Reducing communication delays and improving quality of care with a tuberculosis laboratory information system in resource poor environments: a cluster randomized controlled trial. PLoS ONE |
| title | Reducing communication delays and improving quality of care with a tuberculosis laboratory information system in resource poor environments: a cluster randomized controlled trial. |
| title_full | Reducing communication delays and improving quality of care with a tuberculosis laboratory information system in resource poor environments: a cluster randomized controlled trial. |
| title_fullStr | Reducing communication delays and improving quality of care with a tuberculosis laboratory information system in resource poor environments: a cluster randomized controlled trial. |
| title_full_unstemmed | Reducing communication delays and improving quality of care with a tuberculosis laboratory information system in resource poor environments: a cluster randomized controlled trial. |
| title_short | Reducing communication delays and improving quality of care with a tuberculosis laboratory information system in resource poor environments: a cluster randomized controlled trial. |
| title_sort | reducing communication delays and improving quality of care with a tuberculosis laboratory information system in resource poor environments a cluster randomized controlled trial |
| url | https://doi.org/10.1371/journal.pone.0090110 |
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