Community-based follow-up for late patients enrolled in a district-wide programme for antiretroviral therapy in Lusaka, Zambia
Community-based follow-up for late patients enrolled in a district-wide programme for antiretroviral therapy in Lusaka, Zambia
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DOI：
10.1080/09540120701594776
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发表时间：
2008-01-01
影响因子：
1.7
通讯作者：
Stringer, J. S. A.
中科院分区：
文献类型：
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作者：
Krebs, D. W.;Chi, B. H.;Stringer, J. S. A.
及时遵守临床和药房预约与艾滋病毒感染者接受抗逆转录病毒治疗的良好患者结果密切相关。然而，迄今为止，很少有工作探索错过就诊背后的原因或评估召回患者的规划策略。在这项研究中，我们对晚期患者进行了基于社区的随访，作为赞比亚卢萨卡大规模艾滋病毒护理和治疗计划的一部分。通过当地家庭护理组织网络，我们尝试使用注册时提供的定位信息进行家访以召回患者。 2005 年 5 月至 9 月期间，派出家庭护理人员追踪 1,343 名未预约的患者。其中，554 例 (41%) 由于提供的地址无效、患者已搬家或家中无人而无法追踪。据报道，其余 789 人中，有 359 人（46%）死亡。只有 430 人（被追踪者的 54%，总体 32%）被直接联系并被鼓励返回接受护理。在粗略分析（相对风险 [RR] = 2.5；95%CI = 1.9-3.2）和控制基线体重指数、性别和 CD4 + 计数的多变量分析中，追踪患者返回的可能性较高
Timely adherence to clinical and pharmacy appointments is well correlated with favourable patient outcomes among HIV-infected individuals on antiretroviral therapy. To date, however, there is little work exploring reasons behind missed visits or evaluating programmatic strategies to recall patients. For this study we implemented community-based follow-up of late patients as part of a large-scale programme for HIV care and treatment in Lusaka, Zambia. Through a network of local home-based care organizations, we attempted home visits to recall patients using locator information provided at time of enrolment. Between May and September 2005, home-based caregivers were dispatched to trace 1,343 patients with missed appointments. Of these, 554 (41%) were untraceable because the provided address was invalid, the patient had moved or no one was at the home. Of the remaining 789, 359 (46%) were reported to have died. Only 430 (54% of those traced, 32% overall) were contacted directly and encouraged to return for care. The likelihood of patient return was higher among traced patients in crude analysis (relative risk [RR] = 2.5; 95%CI = 1.9-3.2) and in multivariable analysis controlling for baseline body mass index, sex and CD4 + count