凯尔斯计划:通过全面的以团队为基础的方法改善病毒抑制和护理中的保留,为艾滋病毒感染者和复杂的心理社会需求的人提供护理
Stephanie Sweitzer1, Maddie Giegold2, Yunyun Chen3
1J. Willis Hurst Internal Medicine Residency Program, Emory University School of Medicine, Atlanta, Georgia, USA.
AIDS patient care and STDs
|August 11, 2023
概括
在CARES计划改善了艾滋病毒的护理保留和病毒抑制复杂需求的个人. 这种跨学科模式提供综合服务,增强艾滋病毒感染者面临重大障碍的健康结果.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 健康的社会决定因素
背景情况:
- 在艾滋病毒护理和病毒抑制中持续存在低于最佳的保留时间,特别是在艾滋病毒感染者 (PWH) 面临诸如心理健康状况,物质使用障碍和住房不安全等挑战的情况下.
- 综合护理模式对于解决复杂的心理社会需求和改善PWH健康结果至关重要.
研究的目的:
- 描述 Center for Adherence, Retention, and Engagement Support (CARES) 计划,这是一个针对有复杂需求的PWH的跨学科干预.
- 评估CARES计划在改善艾滋病毒护理中的保留和实现病毒抑制方面的有效性.
主要方法:
- 2011-2017年间,一组119名艾滋病毒感染者 (PWH) 被转到CARES,在24个月的随访期间进行了分析.
- 对CARES参与者的结果 (病毒抑制,在护理中的保留) 与那些被引用但非参与者的结果进行了比较.
- 病毒抑制被定义为<200副本/毫升;保持护理需要每年≥2次医疗访问,间隔≥90天.
主要成果:
- 参与CARES计划 (≥2次访问) 的参与者显著更有可能实现病毒抑制 (aOR 3.50,95% CI 1.19-10.32).
- 参与CARES也显著增加了留在护理中的可能性 (aOR 3.73,95% CI 1.52-9.14).
- 该计划对脆弱的PWH人群的初级和二级结果产生了积极的影响.
结论:
- 该CARES计划有效地提高了艾滋病毒护理和病毒抑制在艾滋病毒感染者中面临复杂的心理社会障碍的保留率.
- 研究结果表明,像CARES这样的综合,跨学科的护理模式对于应对艾滋病毒管理中的多方面的挑战是有价值的.
- 该CARES模型显示,作为可复制的框架,它有望为未来的艾滋病毒治疗计划提供可复制的框架,旨在改善患者的治疗结果.
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