Benefits of task-shifting HIV care to nurses in terms of health-related quality of life in patients initiating antiretroviral therapy in rural district hospitals in Cameroon [Stratall Agence Nationale de Recherche sur le SIDA (ANRS) 12110/Ensemble pour un

Autor: Marie Suzan-Monti, Jérôme Blanche, Patrizia Carrieri, Renée-Cécile Bonono, Eric Delaporte, Bruno Spire, Charles Kouanfack, Christian Laurent, Sylvie Boyer, Camelia Protopopescu
Přispěvatelé: Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
Rok vydání: 2015
Předmět:
Adult
Male
Rural Population
Program evaluation
Gerontology
Anti-HIV Agents
Cost-Benefit Analysis
Health Status
antiretroviral therapy
Population
Nurses
Developing country
HIV Infections
World Health Organization
Quality of life (healthcare)
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Physicians
Humans
Medicine
Pharmacology (medical)
Cameroon
Longitudinal Studies
education
Sida
Monitoring
Physiologic
education.field_of_study
biology
business.industry
Health Policy
Viral Load
Hospitals
District
biology.organism_classification
task-shifting
Confidence interval
CD4 Lymphocyte Count
3. Good health
health-related quality of life
Infectious Diseases
Patient Satisfaction
comprehensive care
Scale (social sciences)
Practice Guidelines as Topic
Disease Progression
Quality of Life
HIV-1
Female
Rural area
business
Follow-Up Studies
Zdroj: HIV Medicine
HIV Medicine, Wiley, 2015, 16 (5), pp.307-318. ⟨10.1111/hiv.12213⟩
HIV Medicine, 2015, 16 (5), pp.307-318. ⟨10.1111/hiv.12213⟩
ISSN: 1464-2662
1468-1293
Popis: International audience; OBJECTIVES:The World Health Organization (WHO) recommends task-shifting HIV care to nurses in low-resource settings with limited numbers of physicians. However, the effect of such task-shifting on the health-related quality of life (HRQL) of people living with HIV (PLHIV) has seldom been evaluated. We aimed to investigate the effect of task-shifting HIV care to nurses on HRQL outcomes in PLHIV initiating antiretroviral therapy (ART) in rural district hospitals in Cameroon.METHODS:Outcomes in PLHIV were longitudinally collected in the 2006-2010 Stratall trial. PLHIV were followed up for 24 months by nurses and/or physicians. Six HRQL dimensions were assessed during face-to-face interviews using the WHO Quality of Life (WHOQOL)-HIV BREF scale: physical health; psychological health; independence level; social relationships; environment; and spirituality/religion/personal beliefs. The degree of task-shifting was estimated using a consultant ratio (i.e. the ratio of nurse-led to physician-led visits). The effect of task-shifting and other potential correlates on HRQL dimensions was explored using a Heckman two-stage approach based on linear mixed models to adjust for the potential bias caused by missing data in the outcomes.RESULTS:Of 1424 visits in 440 PLHIV (70.5% female; median age 36 years; median CD4 count 188 cells/μL at enrolment), 423 (29.7%) were task-shifted to nurses. After multiple adjustment, task-shifting was associated with higher HRQL level for four dimensions: physical health [coefficient 0.7; 95% confidence interval (CI) 0.1-1.2; P = 0.01], psychological health (coefficient 0.5; 95% CI 0.0-1.0; P = 0.05), independence level (coefficient 0.6; 95% CI 0.1-1.1; P = 0.01) and environment (coefficient 0.6; 95% CI 0.1-1.0; P = 0.02).CONCLUSIONS:Task-shifting HIV care to nurses benefits the HRQL of PLHIV. Together with the previously demonstrated comparable clinical effectiveness of physician-based and nurse-based models of HIV care, our results support the WHO recommendation for task-shifting.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje