Integrating diabetes, hypertension and HIV care in sub-Saharan Africa: a Delphi consensus study on international best practice.
Integrating diabetes, hypertension and HIV care in sub-Saharan Africa: a Delphi consensus study on international best practice.
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DOI：
10.1186/s12913-021-07073-0
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发表时间：
2021-11-15
影响因子：
2.8
通讯作者：
Cullen W
中科院分区：
文献类型：
--
作者：
McCombe G;Murtagh S;Lazarus JV;Van Hout MC;Bachmann M;Jaffar S;Garrib A;Ramaiya K;Sewankambo NK;Mfinanga S;Cullen W
尽管艾滋病毒在撒哈拉以南非洲(SSA)成人中的流行率仍然很高，但糖尿病和高血压等非传染性疾病(NCD)的负担正在迅速增加。迫切需要扩大SSA医疗保健系统的能力，以提供非传染性疾病服务，并扩大现有的慢性护理管理途径。这项研究的目的是确定在为预防、识别和治疗艾滋病毒、高血压和糖尿病提供综合服务方面的关键组成部分、成果和最佳做法。连续两轮进行了一项国际、多方利益攸关方e-Delphi共识研究。在第一轮中，24名参与者被要求对27项陈述进行评分，这些陈述的标题分别是“服务提供”和“融合的好处”，按重要性排列。在第二轮中，完成第一轮的16名参与者被展示了来自其他参与者的分数分布以及他们归因于结果的分数，并被要求根据其他参与者的分数反思他们给出的分数，然后如果他们愿意的话，重新计分。9名参与者完成了第二轮。根据第一轮的排名，27项结果中有19项达到了70%的共识门槛。第一轮参与者提出的另外四项成果被添加到第二轮，经参与者审查，31项成果中有22项达到了共识门槛。参与者在两轮中的得分从7分到9分，被认为是有效地为慢性病患者提供综合医疗服务所必需的五个项目，分别是改进艾滋病毒携带者非传染性疾病的数据收集和监测，以提供综合的非传染性疾病/艾滋病毒方案管理，加强药物采购系统，提供设备和获得相关血液测试，为所有慢性病患者提供健康教育，以及加强对多发病患者的持续护理。这项研究强调了可能构成未来复杂干预措施的关键组成部分的成果，以确定撒哈拉以南非洲糖尿病、高血压和艾滋病毒综合保健提供模式。
Although HIV continues to have a high prevalence among adults in sub-Saharan Africa (SSA), the burden of noncommunicable diseases (NCD) such as diabetes and hypertension is increasing rapidly. There is an urgent need to expand the capacity of healthcare systems in SSA to provide NCD services and scale up existing chronic care management pathways. The aim of this study was to identify key components, outcomes, and best practice in integrated service provision for the prevention, identification and treatment of HIV, hypertension and diabetes. An international, multi stakeholder e-Delphi consensus study was conducted over two successive rounds. In Round 1, 24 participants were asked to score 27 statements, under the headings ‘Service Provision’ and ‘Benefits of Integration’, by importance. In Round 2, the 16 participants who completed Round 1 were shown the distribution of scores from other participants along with the score that they attributed to an outcome and were asked to reflect on the score they gave, based on the scores of the other participants and then to rescore if they wished to. Nine participants completed Round 2. Based on the Round 1 ranking, 19 of the 27 outcomes met the 70% threshold for consensus. Four additional outcomes suggested by participants in Round 1 were added to Round 2, and upon review by participants, 22 of the 31 outcomes met the consensus threshold. The five items participants scored from 7 to 9 in both rounds as essential for effective integrated healthcare delivery of health services for chronic conditions were improved data collection and surveillance of NCDs among people living with HIV to inform integrated NCD/HIV programme management, strengthened drug procurement systems, availability of equipment and access to relevant blood tests, health education for all chronic conditions, and enhanced continuity of care for patients with multimorbidity. This study highlights the outcomes which may form key components of future complex interventions to define a model of integrated healthcare delivery for diabetes, hypertension and HIV in sub-Saharan Africa.
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DOI：
10.1097/qad.0000000000001887
发表时间：
2018-07-01
期刊：
AIDS (London, England)
影响因子：
--
作者：
Njuguna B;Vorkoper S;Patel P;Reid MJA;Vedanthan R;Pfaff C;Park PH;Fischer L;Laktabai J;Pastakia SD
通讯作者：
Pastakia SD
成年马拉维人在艾滋病毒护理中的高血压，糖尿病和心血管危险因素的负担：综合服务的后果。
影响因子：
4.5
作者：
Divala OH;Amberbir A;Ismail Z;Beyene T;Garone D;Pfaff C;Singano V;Akello H;Joshua M;Nyirenda MJ;Matengeni A;Berman J;Mallewa J;Chinomba GS;Kayange N;Allain TJ;Chan AK;Sodhi SK;van Oosterhout JJ
通讯作者：
van Oosterhout JJ
影响因子：
2
作者：
Hoffmann, Vivian;Fooks, Jacob R.;Messer, Kent D.
通讯作者：
Messer, Kent D.
影响因子：
3.8
作者：
Hasson, F;Keeney, S;McKenna, H
通讯作者：
McKenna, H
DOI：
10.1073/pnas.1620788114
发表时间：
2017-04-11
影响因子：
11.1
作者：
Medlock, Jan;Pandey, Abhishek;Galvani, Alison P.
通讯作者：
Galvani, Alison P.