Impact of an Enhanced Patient Care Intervention on Viral Suppression Among Patients Living With HIV in Kenya.
J Acquir Immune Defic Syndr
; 90(4): 434-439, 2022 08 01.
Article
in En
| MEDLINE
| ID: mdl-35320121
ABSTRACT
BACKGROUND:
Effective patient-centered interventions are needed to promote patient engagement in HIV care. We assessed the impact of a patient-centered intervention referred to as enhanced patient care (EPC) on viral suppression among unsuppressed patients living with HIV in Kenya.SETTING:
Two rural HIV clinics within the Academic Model Providing Access to Health care.METHODS:
This was a 6-month pilot randomized control trial. The EPC intervention incorporated continuity of clinician-patient relationships, enhanced treatment dialog, and improved patients' clinic appointment scheduling. Provider-patient communication training was offered to all clinicians in the intervention site. We targeted 360 virally unsuppressed patients (1) 240 in the intervention site with 120 randomly assigned to provider-patient communication (PPC) training + EPC and 120 to PPC training + standard of care (SOC) and (2) 120 in the control site receiving SOC. Logistic regression analysis was applied using R (version 3.6.3).RESULTS:
A total of 328 patients were enrolled 110 (92%) PPC training + EPC, 110 (92%) PPC training + SOC, and 108 (90%) SOC. Participants' mean age at baseline was 48 years (SD 12.05 years). Viral suppression 6 months postintervention was 84.4% among those in PPC training + EPC, 83.7% in PPC training + SOC, and 64.4% in SOC ( P ≤ 0.001). Compared with participants in PPC training + EPC, those in SOC had lower odds of being virally suppressed 6 months postintervention (odds ratio = 0.36, 95% confidence interval 0.18 to 0.72).CONCLUSIONS:
PPC training may have had the greatest impact on patient viral suppression. Hence, adequate training and effective PPC implementation strategies are needed.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Infections
Type of study:
Clinical_trials
Limits:
Humans
Country/Region as subject:
Africa
Language:
En
Journal:
J Acquir Immune Defic Syndr
Journal subject:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Year:
2022
Document type:
Article
Affiliation country: