Promoting retention in care: an effective model in an antiretroviral treatment service in South Africa.
Promoting retention in care: an effective model in an antiretroviral treatment service in South Africa.
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促进护理保留：南非抗逆转录病毒治疗服务的有效模式。
DOI：
10.1086/521173
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Bekker,Linda-Gail
中科院分区：
文献类型：
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作者：
Lawn,StephenD;Kaplan,Richard;Wood,Robin;Bekker,Linda-Gail
致编辑——我们饶有兴趣地阅读了 Giordano 及其同事 [1] 撰写的文章，内容涉及美国退伍军人事务医院和诊所在抗逆转录病毒治疗 (ART) 期间将 HIV 感染者留在护理中的困难。尽管治疗的经济障碍很少，但相当一部分患者的护理保留率很差，从而影响了生存概率。作者强调迫切需要制定和实施提高保留率的策略，从而最大限度地发挥 ART 的优势 [1]。在随附的社论中 [2]，Cheever 描述了已在美国其他项目中成功使用的策略，即使用支持服务可以提高患者对医疗护理的参与度并提高保留率。护理保留率也是撒哈拉以南非洲地区 ART 项目的一个主要问题，到 2006 年底，估计那里有 130 万人正在接受 ART，另有 350 万人需要治疗 [3]。尽管该地区对 ART 的早期反应普遍良好 [4]，但失访率差异很大，据报告高达 59%[5]。许多 ART 诊所因患者数量过多而不堪重负。例如，在南非，拥有数千名患者的社区 ART 诊所越来越普遍。随着患者数量的增加，诊所变得人满为患，工作人员不堪重负，增加了保留患者的挑战。人力资源的缺乏大大加剧了这个问题。
To the Editor—We read with interest the article by Giordano and colleagues [1] regarding the difficulties of retaining HIV-infected patients within care during antiretroviral therapy (ART) in US veterans affairs hospitals and clinics. Despite few financial barriers to treatment, retention in care was poor among a substantial portion of patients, compromising survival probability. The authors highlighted the critical need to develop and implement strategies to improve retention, thereby maximizing the benefits of ART [1]. In the accompanying editorial [2], Cheever described strategies that have been used successfully in other programs in the United States, whereby use of support services resulted in greater engagement of patients in their medical care and enhanced retention.Retention in care is also a major issue for ART programs in sub-Saharan Africa, where an estimated 1.3 million people were receiving ART by the end of 2006 and a further 3.5 million people were in need of treatment [3]. Although early responses to ART have been found to be generally good in the region [4], rates of loss to follow-up are extremely variable, with reported rates of up to 59%[5]. Many ART clinics are straining under the sheer number of patients. In South Africa, for example, community-based ART clinics with case loads of several thousand patients are increasingly common. As patient numbers grow, clinics become overcrowded and staff are over-stretched, increasing the challenge of patient retention. Lack of human resources greatly amplifies the problem.