Provider guidance for linking patients to antiretroviral therapy adherence interventions: recommendations from an IAPAC advisory committee on adherence monitoring and support.
Provider guidance for linking patients to antiretroviral therapy adherence interventions: recommendations from an IAPAC advisory committee on adherence monitoring and support.
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DOI：
10.1177/1545109712474844
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发表时间：
2013-03-01
影响因子：
--
通讯作者：
Young, Benjamin
中科院分区：
文献类型：
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作者：
Amico, K Rivet;Zuniga, Jose M;Young, Benjamin
要实现持续的病毒学抑制，通常需要高水平、持续的抗逆转录病毒治疗(ART)坚持。最近发布的关于进入和保留护理以及遵守抗逆转录病毒疗法的全球指南包括作为艾滋病毒临床管理的标准部分监测和支持抗逆转录病毒药物治疗的建议。目前正在开发若干工具，以促进这些循证准则的传播和执行。最近开发了一种袖珍指南方案信息计划(GRIP)指南，作为一种快速参考工具，用于总结高影响力、强有力的循证建议，并提供有效的单一评估项目，用于收集患者自我报告的依从性估计，作为标准临床护理的一部分。回顾了该工具的发展和预期用途，并提供了其他建议，以促进临床医生和患者之间的简短讨论，将患者与适当的资源、策略或计划联系起来。还讨论了该工具的局限性和要避免的场景。由于相当大比例的抗逆转录病毒治疗患者试图达到或维持足够高的依从率，主动监测患者对抗逆转录病毒药物的遵从性以及患者与所需资源的联系是高质量艾滋病毒护理的关键组成部分。快速参考GRIP指南旨在成为更大的方法包的一部分，以识别需要依从性支持的患者，而不考虑当前的病毒载量，并帮助提供者将患者与可用的资源联系起来。
High, persistent levels of antiretroviral therapy (ART) adherence are generally required to achieve sustained virologic suppression. Recently published global guidelines on entry into and retention in care and ART adherence include recommendations for monitoring and supporting ART adherence as a standard part of HIV clinical management. Several tools to facilitate the dissemination and implementation of these evidence-based guidelines are under development. A pocket-size Guidelines Regimen Information Program (GRIP) guide was recently developed as a quick reference tool to summarize high impact, strong evidence-based recommendations and to provide a validated single assessment item for use in collecting self-reported adherence estimations from patients as part of standard clinical care. The tool's development and intended use are reviewed and additional recommendations provided to facilitate a brief clinician-patient discussion to link patients to appropriate resources, strategies, or programs. Limitations of the tool and scenarios to avoid are also discussed. With a sizable proportion of individuals on ART trying to achieve or sustain sufficiently high rates of adherence, proactive monitoring of ART adherence and linkage of patients to needed resources is a critical component of high-quality HIV care. The quick reference GRIP guide is intended to be a part of a larger package of approaches to identify patients in need of adherence support regardless of current viral load and to help providers link patients with the available resources.