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http://hdl.handle.net/11375/28013
Title: | Measures of retention in HIV care: A study within a review |
Authors: | Rehman, Nadia |
Advisor: | Mbuagbaw, Lawrence |
Department: | Health Research Methodology |
Keywords: | HIV; retention in care;definitions; heterogenous;components |
Publication Date: | 2022 |
Abstract: | Introduction Retention in HIV care is critical for PLHIV. However, retention in HIV care is not measured uniformly across studies. The aim of this study within a review (SWAR) is to describe the diversity in definitions used for retention in HIV care in randomized controlled trials. Methods We conducted a SWAR, drawing data from an overview of systematic reviews on interventions to improve the HIV care cascade. A comprehensive and exhaustive search was conducted of the following databases: PubMed, Excerpta Medica data BASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Web of Science, and the Cochrane Library. We identified randomized controlled trials (RCTs) of interventions to improve retention in care for people living with HIV (PLHIV). First, from the included studies in systematic reviews and second using targeted searches for RCTs. Only English language systematic reviews were included, but RCTs in any language were eligible. Data were screened and extracted in duplicate using pre-set criteria, with arbitration as needed. We identified distinct components from the definitions used to measure retention. The components were further categorized based on the similarities between them. We described the components narratively and presented the definitions in tables. Results We identified 8001 records, after a duplication check, 4147 unique titles and abstracts were examined for relevancy, leaving 744 articles. Full-text screening of the articles resulted in 50 articles that measured retention and provided 59 definitions for retention in care. Of the included studies, 11(22%) were conducted in low-income countries, 12(24%) were conducted in lower-middle-income and upper-middle-income countries, and 13(26%) were conducted in high-income countries. We identified ten different components used to define retention. These components are follow-up times (83%), administrative records (8%), clinical visits (61%), gap scores (8%), group-level measures (17%), lab records (15%), pharmacy-based measures (29%), scheduled visits (27%) and visit counts (17%). The most frequently used components are follow-up times (n=49), and the easiest to measure are retention data derived from administrative records (n=5). We put the components into categories based on the similarities between them. Conclusion We identified existing definitions of retention in HIV care and the commonly used components in the definitions. This compilation of the definitions and identification of the components may provide a framework for developing the standard globally agreed-upon definition of retention in HIV care. |
Description: | This is the first comprehensive systematic review of the definitions used for retention measures in HIV care. This review provides a compilation of existing definitions of retention in HIV care in randomized controlled trials. In summary, we report very little consensus regarding definitions of retention in HIV care in the research literature. We report and compare definitions of retention so researchers can weigh their definitions with the body of definitions, with the ultimate aim of motivating the research community to establish a clear and unambiguous definition. This work will provide resources for researchers to recommend a definition of retention. Future research is needed to seek practitioners’ views on the most unambiguous, explicit definition of retention. This is only a first step in research toward a standard definition of retention. |
URI: | http://hdl.handle.net/11375/28013 |
Appears in Collections: | Open Access Dissertations and Theses |
Files in This Item:
File | Description | Size | Format | |
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Nadia_Rehman_August 2022_MSc.pdf | 738.15 kB | Adobe PDF | View/Open |
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