CD4 Reminder Update (#1303)

Co-authored-by: Angie-540 <[email protected]> Co-authored-by: Drizzentic <[email protected]>
AMPATH · Aug 3, 2023 · 7111508 · 7111508
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commit 7111508
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Showing 4 changed files with 154 additions and 70 deletions.
diff --git a/app/reporting-framework/base-mysql.report.js b/app/reporting-framework/base-mysql.report.js
@@ -34,7 +34,6 @@ import * as referral_aggregate from './json-reports/referral-aggregate.json';
 import * as referral_peer_aggregate from './json-reports/referral-peer-aggregate.json';
 import * as referral_patient_list_peer_base from './json-reports/referral-peer-base.json';
 import * as cdm_dataset_base from './json-reports/cdm/cdm-dataset-base.json';
-
 import * as starting_art_aggregation_age15 from './json-reports/starting-art-aggregation-age15.json';
 import * as starting_art_base_age15 from './json-reports/starting-art-base-age15.json';
 import * as starting_art_disaggregation_age15 from './json-reports/starting-art-disaggregation-age15.json';

diff --git a/app/reporting-framework/json-reports/clinical-reminder-report.json b/app/reporting-framework/json-reports/clinical-reminder-report.json
@@ -110,6 +110,14 @@
         "type": "left",
         "joinCondition": "t1.person_id = t7.patient_id AND t7.program_id = 27 AND t7.date_completed IS NULL"
       }
+    },
+    {
+      "table": "etl.flat_hiv_summary_ext",
+      "alias": "t11",
+      "join": {
+        "type": "left",
+        "joinCondition": "t11.encounter_id = t1.encounter_id "
+      }
     }
   ],
   "columns": [
@@ -168,7 +176,7 @@
       "alias": "get_cd4_count_coded",
       "expressionType": "simple_expression",
       "expressionOptions": {
-        "expression": "CASE WHEN ls.cd4_1 IS NULL THEN 1 WHEN (ls.cd4_1 <= 200) AND (TIMESTAMPDIFF(MONTH, ls.cd4_1_date, '{referenceDate}') > 6) THEN 2 WHEN (ls.cd4_1 > 200 AND ls.cd4_2 <= 200) AND (TIMESTAMPDIFF(MONTH, ls.cd4_1_date, '{referenceDate}') > 6) THEN 3 WHEN ls.cd4_2 IS NULL AND (TIMESTAMPDIFF(MONTH, ls.cd4_1_date, '{referenceDate}') > 6) THEN 4   ELSE 0 END"
+        "expression": "CASE WHEN ls.arv_start_date >= '2023-04-01' AND ls.cd4_1 IS NULL THEN 1 WHEN (ls.vl_1 > 1000) THEN 2 WHEN (TIMESTAMPDIFF(MONTH, ls.rtc_date, '{referenceDate}') >= 3) THEN 3 WHEN ( t11.on_cm_treatment = 1 AND t11.cm_treatment_end_date IS NULL) AND (TIMESTAMPDIFF(MONTH, ls.cd4_1_date, '{referenceDate}') >= 6) THEN 4 ELSE 0 END"
       }
     },
     {
@@ -187,6 +195,14 @@
         "expression": "case when timestampdiff(day,ls.cd4_order_date, '{referenceDate}') > 30 and ls.cd4_1_date is null or ls.cd4_order_date > ls.cd4_1_date then timestampdiff(day,ls.cd4_order_date, '{referenceDate}') else 0 end "
       }
     },
+    {
+      "type": "derived_column",
+      "alias": "next_rtc_duration",
+      "expressionType": "simple_expression",
+      "expressionOptions": {
+        "expression": "TIMESTAMPDIFF(MONTH, ls.rtc_date, '{referenceDate}')"
+      }
+    },
     {
       "type": "derived_column",
       "alias": "is_on_inh_treatment",
@@ -208,6 +224,11 @@
       "alias": "last_encounter_date",
       "column": "ls.encounter_datetime"
     },
+    {
+      "type": "simple_column",
+      "alias": "latest_CD4_Date",
+      "column": "ls.cd4_1_date"
+    },
     {
       "type": "simple_column",
       "alias": "on_tb_tx",
@@ -238,6 +259,7 @@
       "alias": "arv_start_date",
       "column": "t1.arv_start_date"
     },
+
     {
       "type": "simple_column",
       "alias": "cur_arv_meds",

diff --git a/dao/patient/etl-patient-dao.js b/dao/patient/etl-patient-dao.js
@@ -24,12 +24,20 @@ module.exports = (function () {
             uuid
           ];
     var queryParts = {
-      columns: request.query.fields || '*',
+      columns: request.query.fields || '*,  t3.*',
+      columns: request.query.fields || '*, t3.*',
       table: 'etl.flat_hiv_summary_v15b',
       where: whereClause,
+      leftOuterJoins: [
+        ['etl.flat_hiv_summary_ext', 't3', 't1.encounter_id = t3.encounter_id']
+      ],
+      leftOuterJoins: [
+        ['etl.flat_hiv_summary_ext', 't3', 't1.encounter_id = t3.encounter_id']
+      ],
       order: order || [
         {
-          column: 'encounter_datetime',
+          column: 't1.encounter_datetime',
+          column: 't1.encounter_datetime',
           asc: false
         }
       ],
@@ -44,7 +52,6 @@ module.exports = (function () {
       offset: request.query.startIndex,
       limit: 1000
     };
-
     var encounterTypeNames = {};
     //get encounter type Name
     var encounterNamesPromise = db.queryDb(qParts);

diff --git a/service/patient-reminder.service.js b/service/patient-reminder.service.js
@@ -25,7 +25,7 @@ function viralLoadReminders(data) {
   let reminders = [];
 
   let labMessage = 'Last viral load: none';
-  let requires = 'Patient requires viral load test. ';
+  let requires = 'Patient requires viral load test';
   if (data.last_vl_date) {
     labMessage =
       'Last viral load: ' +
@@ -45,7 +45,7 @@ function viralLoadReminders(data) {
     reminders.push({
       message:
         requires +
-        'Patients who are between 0-24 years old and 3 months after ART initiation ' +
+        '.Patients who are between 0-24 years old and 3 months after ART initiation ' +
         'require a viral load test.' +
         labMessage,
       title: 'Viral Load Reminder',
@@ -59,7 +59,7 @@ function viralLoadReminders(data) {
     reminders.push({
       message:
         requires +
-        'Patients who are between 0-24 years old ' +
+        '.Patients who are between 0-24 years old ' +
         'require a viral load test every 6 months. ' +
         labMessage,
       title: 'Viral Load Reminder',
@@ -73,7 +73,7 @@ function viralLoadReminders(data) {
     reminders.push({
       message:
         requires +
-        'A Patient with Viral Load that is more than 200 requires a viral load test every 3 months. ' +
+        '.A Patient with Viral Load that is more than 200 requires a viral load test every 3 months. ' +
         labMessage,
       title: 'Viral Load Reminder',
       type: 'danger',
@@ -87,7 +87,7 @@ function viralLoadReminders(data) {
     reminders.push({
       message:
         requires +
-        'Patients older than 25 years and newly on ART require ' +
+        '.Patients older than 25 years and newly on ART require ' +
         'a viral load test after 12 months. ' +
         labMessage,
       title: 'Viral Load Reminder',
@@ -104,7 +104,7 @@ function viralLoadReminders(data) {
     reminders.push({
       message:
         requires +
-        'Patients older than 25 years and on ART for more than 1 year require ' +
+        '.Patients older than 25 years and on ART for more than 1 year require ' +
         'a viral load test every year. ' +
         labMessage,
       title: 'Viral Load Reminder',
@@ -118,7 +118,7 @@ function viralLoadReminders(data) {
     reminders.push({
       message:
         requires +
-        'Patients older than 25 years and 3 months after ART initiation require a viral load test. ' +
+        '.Patients older than 25 years and 3 months after ART initiation require a viral load test. ' +
         labMessage,
       title: 'Viral Load Reminder',
       type: 'danger',
@@ -131,7 +131,7 @@ function viralLoadReminders(data) {
     reminders.push({
       message:
         requires +
-        'A Patient with Viral Load that is more than 200 requires a viral load test every 3 months. ' +
+        '.A Patient with Viral Load that is more than 200 requires a viral load test every 3 months. ' +
         labMessage,
       title: 'Viral Load Reminder',
       type: 'danger',
@@ -145,7 +145,7 @@ function viralLoadReminders(data) {
     reminders.push({
       message:
         requires +
-        'A pregnant or breastfeeding patient with vl > 200 requires ' +
+        '.A pregnant or breastfeeding patient with vl > 200 requires ' +
         'a viral load test every 3 months. ' +
         labMessage,
       title: 'Viral Load Reminder',
@@ -159,7 +159,7 @@ function viralLoadReminders(data) {
     reminders.push({
       message:
         requires +
-        'A pregnant or breastfeeding patient requires ' +
+        '.A pregnant or breastfeeding patient requires ' +
         'a viral load test every 6 months. ' +
         labMessage,
       title: 'Viral Load Reminder',
@@ -173,7 +173,10 @@ function viralLoadReminders(data) {
   // all patients
   else if (data.needs_vl_coded === 7) {
     reminders.push({
-      message: requires + ' 3 months after Regimen Modification ' + labMessage,
+      message:
+        requires +
+        '3 months after Regimen Change done on ' +
+        Moment(data.last_encounter_date).format('DD-MM-YYYY'),
       title: 'Viral Load Reminder',
       type: 'danger',
       display: {
@@ -185,70 +188,123 @@ function viralLoadReminders(data) {
 
   return reminders;
 }
+
 function cd4TestReminder(data) {
   let reminders = [];
-
+  let suspected =
+    'Suspected Treatment Failure: Viral load is: ' + data.viral_load + '.';
+  if (data.viral_load < 1000) {
+    suspected = '';
+  }
   switch (data.get_cd4_count_coded) {
     case 1:
-      reminders.push({
-        message: 'Patient requires a baseline CD4',
-        title: 'CD4 Reminder',
-        type: 'success',
-        display: {
-          banner: true,
-          toast: true
-        }
-      });
+      if (data.next_rtc_duration > 3) {
+        reminders.push({
+          message:
+            suspected +
+            ' Patient requires a baseline CD4 test and has missed clinic by more than 3 months.',
+          title: 'CD4 Reminder',
+          type: 'success',
+          display: {
+            banner: true,
+            toast: true
+          }
+        });
+      } else {
+        reminders.push({
+          message: suspected + ' Patient requires a baseline CD4',
+          title: 'CD4 Reminder',
+          type: 'success',
+          display: {
+            banner: true,
+            toast: true
+          }
+        });
+      }
       break;
     case 2:
-      reminders.push({
-        message:
-          'Patient requires CD4. Latest CD4 is  ' +
-          data.latest_cd4_count +
-          ', done ' +
-          data.months_since_cd4_count +
-          ' months ago.',
-        title: 'CD4 Reminder',
-        type: 'success',
-        display: {
-          banner: true,
-          toast: true
-        }
-      });
+      if (data.months_since_cd4_count > 6) {
+        reminders.push({
+          message:
+            suspected +
+            ' Patient requires CD4 test. Latest CD4 is  ' +
+            data.latest_cd4_count +
+            ', done (' +
+            Moment(data.latest_CD4_Date).format('DD-MM-YYYY') +
+            ') ' +
+            data.months_since_cd4_count +
+            ' months ago.',
+          title: 'CD4 Reminder',
+          type: 'success',
+          display: {
+            banner: true,
+            toast: true
+          }
+        });
+      } else if (!data.months_since_cd4_count) {
+        reminders.push({
+          message: suspected + ' Patient requires CD4 test.',
+          title: 'CD4 Reminder',
+          type: 'success',
+          display: {
+            banner: true,
+            toast: true
+          }
+        });
+      }
       break;
     case 3:
-      reminders.push({
-        message:
-          'Patient requires CD4 confirmation. Previous CD4 was ' +
-          data.previous_cd4_count +
-          ' Latest CD4 is  ' +
-          data.latest_cd4_count +
-          ', done ' +
-          data.months_since_cd4_count +
-          ' months ago.',
-        title: 'CD4 Reminder',
-        type: 'success',
-        display: {
-          banner: true,
-          toast: true
-        }
-      });
+      if (!data.latest_cd4_count) {
+        reminders.push({
+          message:
+            suspected +
+            ' Patient requires a baseline CD4 test and has missed clinic by more than 3 months.',
+          title: 'CD4 Reminder',
+          type: 'success',
+          display: {
+            banner: true,
+            toast: true
+          }
+        });
+      } else {
+        reminders.push({
+          message:
+            suspected +
+            ' Patient requires CD4 test. Patient missed clinic by more than 3 months. Latest CD4 is  ' +
+            data.latest_cd4_count +
+            ', and latest CD4 done on (' +
+            Moment(data.latest_CD4_Date).format('DD-MM-YYYY') +
+            ') ' +
+            data.months_since_cd4_count +
+            ' months ago.',
+          title: 'CD4 Reminder',
+          type: 'success',
+          display: {
+            banner: true,
+            toast: true
+          }
+        });
+      }
       break;
     case 4:
-      reminders.push({
-        message:
-          'Patient requires CD4 confirmation. First CD4 is  ' +
-          data.latest_cd4_count +
-          ', done ' +
-          data.months_since_cd4_count +
-          ' months ago.',
-        title: 'CD4 Reminder',
-        type: 'success',
-        display: {
-          banner: true,
-          toast: true
-        }
-      });
+      if (data.months_since_cd4_count >= 6) {
+        reminders.push({
+          message:
+            ' Patient on cryptococcal treatment, requires CD4 test.  Latest CD4 is  ' +
+            data.latest_cd4_count +
+            ', done (' +
+            Moment(data.latest_CD4_Date).format('DD-MM-YYYY') +
+            ') ' +
+            data.months_since_cd4_count +
+            ' months ago.',
+          title: 'CD4 Reminder',
+          type: 'success',
+          display: {
+            banner: true,
+            toast: true
+          }
+        });
+      }
       break;
     default:
   }