Evaluation of referral letters to the antiretroviral therapy outpatient specialist clinic of the tertiary health facility in Ilorin, Nigeria.

Abstract

Human immunodeficiency virus (HIV) disease is a chronic medical condition that requires lifelong treatment. Specialist care is of importance in its management and referral process to a specialist is mostly initiated through a referral letter. The ability to design a good management plan during consultation depends on the quality of clinical information in the referral. This study was designed to assess the information provided in referral letters presented to Antiretroviral Therapy (ART) outpatient specialist clinic in a tertiary hospital in Nigeria

It was a retrospective study conducted between January and June 2022. All referral presented to ART clinic on clinic days were reviewed for information provided using a data capture form.

A total of 142 referrals were analyzed. The majority of the referral provided information on patient identifiers. Information on clinical parameters considered important for quality review and management were generally unsatisfactory. Less than a quarter of the referral provided information on laboratory investigations like cluster of differentiation 4 count. Majority (97.9%) of the referrals stated the reason for the referral but physical examination findings and medication history were only reported in 38.7% and 43% respectively.

Referral letters to ART clinic were deficient in the information needed for quality review. The deficiencies delayed patient management. Institution of measures to address the deficiencies will help to improve HIV care. The use of a structured referral form and training of doctors on the required information in a referral letter will also impact positively on HIV care.