Organization of care for persons with HIV-infection: a systematic review

被引:5
|
作者
Handford, Curtis D. [1 ]
Tynan, Anne-Marie [2 ]
Agha, Ayda [2 ]
Rzeznikiewiz, Damian [1 ]
Glazier, Richard H. [1 ,2 ]
机构
[1] St Michaels Hosp, Dept Family & Community Med, Toronto, ON, Canada
[2] St Michaels Hosp, Ctr Urban Hlth Solut, Toronto, ON, Canada
关键词
HIV; organization of care; case management; outreach; multi-disciplinary care; multifaceted treatment; systematic review; HUMAN-IMMUNODEFICIENCY-VIRUS; TYPE-2; DIABETES-MELLITUS; CASE-MANAGEMENT; DEVELOPING-COUNTRIES; MEDICAL-CARE; COLLABORATIVE CARE; PROGRAM; HIV/AIDS; INTERVENTION; ADHERENCE;
D O I
10.1080/09540121.2016.1199846
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The objective of this systematic review was to examine the effectiveness of the organization of care: case management, multidisciplinary care, multi-faceted treatment, hours of service, outreach programs and health information systems on medical, immunological, virological, psychosocial and economic outcomes for persons living with HIV/AIDS. We searched PubMed (MEDLINE) and 10 other electronic databases from 1 January 1980 to April, 2012 for both experimental and controlled observational studies. Thirty-three studies met the inclusion criteria. Eleven studies were randomized controlled trials (RCTs), three of which were conducted in low-middle income settings. Patient characteristics, study design, organization measures and outcomes data were abstracted independently by two reviewers from all studies. A risk of bias tool was applied to RCTs and a separate tool was used to assess the quality of observational studies. This review concludes that case management interventions were most consistently associated with improvements in immunological outcomes but case management demonstrates no clear association with other outcome measures. The same mixed results were also identified for multidisciplinary and multi-faceted care interventions. Eight studies with an outreach intervention were identified and demonstrated improvements or non-inferiority with respect to mortality, receipt of antiretroviral medications, immunological outcomes, improvements in healthcare utilization and lower reported healthcare costs when compared to usual care. Of the interventions examined in this review, sustained in-person case management and outreach interventions were most consistently associated with improved medical and economic outcomes, in particular antiretroviral prescribing, immunological outcomes and healthcare utilization. No firm conclusions can be reached about the impact of any one intervention on patient mortality.
引用
收藏
页码:807 / 816
页数:10
相关论文
共 50 条
  • [31] UNDIAGNOSED HIV-INFECTION IN ACUTE CARE HOSPITALS
    LURIE, P
    LOWE, RA
    AVINS, AL
    PHILLIPS, KA
    KAHN, JG
    FRANKS, PE
    CICCARONE, DH
    NEW ENGLAND JOURNAL OF MEDICINE, 1992, 327 (25): : 1815 - 1816
  • [32] HIV-INFECTION AND THE HEALTH-CARE WORKER
    WEISS, SH
    MEDICAL CLINICS OF NORTH AMERICA, 1992, 76 (01) : 269 - 280
  • [33] HIV-INFECTION AND PREGNANCY IN THE PRIMARY CARE SETTING
    KATZPOLLAK, H
    CLINICAL RESEARCH, 1990, 38 (02): : A715 - A715
  • [34] ASYMPTOMATIC HIV-INFECTION - A PRIMARY CARE DISEASE
    JEWELL, ME
    SWEET, DE
    POSTGRADUATE MEDICINE, 1992, 92 (05) : 155 - &
  • [35] HIV-INFECTION RISK TO NONHEALTH CARE WORKERS
    GERSHON, RM
    VLAHOV, D
    NELSON, KE
    AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL, 1990, 51 (12): : A807 - A809
  • [36] ASSESSING HIV-INFECTION IN PRIMARY CARE PRACTICE
    MAKADON, HJ
    JOURNAL OF GENERAL INTERNAL MEDICINE, 1991, 6 (01) : S2 - S7
  • [37] Optimizing care for persons with HIV infection
    Hecht, FM
    Wilson, IB
    Wu, AW
    Cook, RL
    Turner, BJ
    ANNALS OF INTERNAL MEDICINE, 1999, 131 (02) : 136 - 143
  • [38] HIV-INFECTION
    MAASS, G
    DEUTSCHE MEDIZINISCHE WOCHENSCHRIFT, 1987, 112 (30) : 1187 - 1187
  • [39] HIV-INFECTION
    NOBLE, PJ
    NEW ZEALAND MEDICAL JOURNAL, 1991, 104 (913) : 236 - 236
  • [40] HIV-infection
    Wasmuth, J. -C.
    Rockstroh, J. K.
    DEUTSCHE MEDIZINISCHE WOCHENSCHRIFT, 2007, 132 (13) : 673 - 683