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Related Experiment Video

Updated: May 10, 2025

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Using an automated decision support tool to improve HIV prescribing: A feasibility study.

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  • 1MRCP, South Tees NHS Foundation Trust, Middlesbrough, UK.

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A new decision support tool (DST) shows promise for optimizing antiretroviral therapy (ART) prescribing. This tool could improve cost-effectiveness and patient-clinician shared decision-making for HIV treatment.

Keywords:
HIVantiretroviraldecision support tool

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Area of Science:

  • Infectious Diseases
  • Pharmacoeconomics
  • Health Informatics

Background:

  • Antiretroviral therapy (ART) selection for people living with HIV (PLWH) is complex, influenced by individual factors and clinician judgment.
  • The British HIV Association (BHIVA) promotes cost-effective prescribing and shared decision-making.
  • Evaluating novel tools for optimizing ART regimens is crucial for patient care and resource management.

Purpose of the Study:

  • To assess the acceptability and potential impact of a prototype automated decision support tool (DST) for ART prescribing.
  • To improve the safety, individualization, and cost-effectiveness of ART regimens.
  • To align prescribing practices with BHIVA guidelines and patient preferences.

Main Methods:

  • A survey of PLWH and clinicians assessed treatment preferences and DST acceptability.
  • A DST was developed to interpret electronic patient record data against 2022 BHIVA guidelines for ART switch options.
  • The DST was applied to a cohort of patients receiving ART, with potential cost savings calculated.

Main Results:

  • 86.7% of PLWH respondents were open to switching to more cost-effective ART.
  • While most clinicians prioritized lower-cost treatments, awareness of ART costs was low (38%).
  • Potential monthly cost savings of 28.4% (£26,630.25) were identified for eligible patients.

Conclusions:

  • A DST utilizing BHIVA recommendations and routine data may be acceptable to patients and clinicians.
  • The DST has the potential to achieve significant cost savings in ART prescribing.
  • A considerable number of PLWH are willing to consider ART changes for cost-effectiveness.