tailieunhanh - báo cáo khoa học: "Task shifting and integration of HIV care into primary care in South Africa: The development and content of the streamlining tasks and roles to expand treatment and care for HIV (STRETCH) intervention"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Task shifting and integration of HIV care into primary care in South Africa: The development and content of the streamlining tasks and roles to expand treatment and care for HIV (STRETCH) intervention | Uebel et al. Implementation Science 2011 6 86 http content 6 1 86 Implementation Science IMPLEMENTATION SCIENCE RESEARCH Open Access Task shifting and integration of HIV care into primary care in South Africa The development and content of the streamlining tasks and roles to expand treatment and care for HIV STRETCH intervention if I E I I Lx zx I 1 21 I z D E x i z-x I I 1 3 t rA I zx I I_I I vs Dzx Lx I I rzi 4t A I I I I E A A zx II zx zx F-TZX21 k A X o x Lx m x zx zx 5 Kerry E Uebel Lara R Fairall Dingie HCJ van Kensburg Willie F Moiientze Max O Bachmann Simon Lewin6 7t Merrick Zwarenstein8 9 10 Christopher J Colvin11 Daniella Georgeu1 Pat Mayers12 Gill M Faris1 Carl Lombard13 and Eric D Bateman14 15 Abstract Background Task shifting and the integration of human immunodeficiency virus HIV care into primary care services have been identified as possible strategies for improving access to antiretroviral treatment ART . This paper describes the development and content of an intervention involving these two strategies as part of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV STRETCH pragmatic randomised controlled trial. Methods Developing the intervention The intervention was developed following discussions with senior management clinicians and clinic staff. These discussions revealed that the establishment of separate antiretroviral treatment services for HIV had resulted in problems in accessing care due to the large number of patients at ART clinics. The intervention developed therefore combined the shifting from doctors to nurses of prescriptions of antiretrovirals ARVs for uncomplicated patients and the stepwise integration of HIV care into primary care services. Results Components of the intervention The intervention consisted of regulatory changes training and guidelines to support nurse ART prescription local management teams an implementation toolkit and a flexible phased introduction. Nurse .