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Effectiveness of Patient Adherence Groups as a Model of Care for Stable Patients on Antiretroviral Therapy in
| Content Provider | CiteSeerX |
|---|---|
| Author | Luque-Fern, Miguel Angel Cutsem, Gilles Van Goemaere, Eric Hilderbr, Katherine Schomaker, Michael Mantangana, Nompumelelo Mathee, Shaheed Dubula, Vuyiseka Ford, Nathan Hernán, Miguel A. Boulle, Andrew |
| Abstract | Background: Innovative models of care are required to cope with the ever-increasing number of patients on antiretroviral therapy in the most affected countries. This study, in Khayelitsha, South Africa, evaluates the effectiveness of a group-based model of care run predominantly by non-clinical staff in retaining patients in care and maintaining adherence. Methods and Findings: Participation in ‘‘adherence clubs’ ’ was offered to adults who had been on ART for at least 18 months, had a current CD4 count.200 cells/ml and were virologically suppressed. Embedded in an ongoing cohort study, we compared loss to care and virologic rebound in patients receiving the intervention with patients attending routine nurse-led care from November 2007 to February 2011. We used inverse probability weighting to estimate the intention-to-treat effect of adherence club participation, adjusted for measured baseline and time-varying confounders. The principal outcome was the combination of death or loss to follow-up. The secondary outcome was virologic rebound in patients who were virologically suppressed at study entry. Of 2829 patients on ART for.18 months with a CD4 count above 200 cells/ml, 502 accepted club participation. At the end of the study, 97 % of club patients remained in care compared with 85 % of other |
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| Access Restriction | Open |
| Content Type | Text |
