Evaluation of a health system intervention to improve virological management in an antiretroviral programme at a municipal clinic in central Durban.
HIV-1 infected
antiretroviral care or management
health strengthening systems interventions
retention in care
virological suppression
Journal
Southern African journal of HIV medicine
ISSN: 2078-6751
Titre abrégé: South Afr J HIV Med
Pays: South Africa
ID NLM: 100965417
Informations de publication
Date de publication:
2019
2019
Historique:
received:
21
05
2019
accepted:
05
07
2019
entrez:
17
10
2019
pubmed:
17
10
2019
medline:
17
10
2019
Statut:
epublish
Résumé
With the largest antiretroviral therapy (ART) programme globally, demand for effective HIV management is increasing in South Africa. While viral load (VL) testing is conducted, VL follow-up and management are sub-optimal. The objective of this study was to address gaps in the VL cascade to improve VL testing and management. Antiretroviral therapy records were sampled for an in-depth review. The study team then reviewed individual records, focusing on ART management, virological suppression and retention. Multifaceted interventions focused on virological control, including a clinical summary chart for ART care; streamlining laboratory results receipt and management; monitoring VL suppression, flagging virological failure and missed visits for follow-up; down-referral of stable patients eligible for the chronic club system; and training of personnel and patients. Pre-intervention, 78% (94/120) of eligible patients had VL tests, versus 92% (145/158) post-intervention ( Service delivery was streamlined to facilitate HIV services by focusing on VL test monitoring, protocol training and accessibility of results, thereby improving clinical management.
Sections du résumé
BACKGROUND
BACKGROUND
With the largest antiretroviral therapy (ART) programme globally, demand for effective HIV management is increasing in South Africa. While viral load (VL) testing is conducted, VL follow-up and management are sub-optimal.
OBJECTIVES
OBJECTIVE
The objective of this study was to address gaps in the VL cascade to improve VL testing and management.
METHODS
METHODS
Antiretroviral therapy records were sampled for an in-depth review. The study team then reviewed individual records, focusing on ART management, virological suppression and retention. Multifaceted interventions focused on virological control, including a clinical summary chart for ART care; streamlining laboratory results receipt and management; monitoring VL suppression, flagging virological failure and missed visits for follow-up; down-referral of stable patients eligible for the chronic club system; and training of personnel and patients.
RESULTS
RESULTS
Pre-intervention, 78% (94/120) of eligible patients had VL tests, versus 92% (145/158) post-intervention (
CONCLUSION
CONCLUSIONS
Service delivery was streamlined to facilitate HIV services by focusing on VL test monitoring, protocol training and accessibility of results, thereby improving clinical management.
Identifiants
pubmed: 31616575
doi: 10.4102/sajhivmed.v20i1.985
pii: HIVMED-20-985
pmc: PMC6779997
doi:
Types de publication
Journal Article
Langues
eng
Pagination
985Informations de copyright
© 2019. The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
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