South Africa's new Central Chronic Medicine Dispensing and Distribution program: assessing the clinic, patient, and community impact
南非新的中央慢性药物配发和分配计划:评估诊所、患者和社区的影响
基本信息
- 批准号:9751392
- 负责人:
- 金额:$ 67.63万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2018
- 资助国家:美国
- 起止时间:2018-07-26 至 2023-05-31
- 项目状态:已结题
- 来源:
- 关键词:AdherenceAdministratorAdoptedAdoptionAfrica South of the SaharaAfricanBehavioral SciencesBiometryCaringCharacteristicsChronicChronic CareChurchClientClinicClinicalCohort StudiesCommunitiesCongestiveContinuity of Patient CareCountryDataDropsEffectivenessElectronic Health RecordEnrollmentEpidemiologyFaceGoalsGovernmentHIVHIV antiretroviralHealthHealth ExpendituresHealth PersonnelHealth care facilityHealth systemHuman immunodeficiency virus testImprove AccessIndividualInterdisciplinary StudyInterventionLifeLife ExpectancyMedicineMethodsModelingMunicipalitiesOutcomeParticipantPatientsPharmaceutical PreparationsPharmacy SchoolsPlayPoliciesPolicy MakerPopulationPopulation ProgramsPositioning AttributePrevalencePrivatizationPublic HealthPublic SectorQualitative MethodsQuality of CareRecommendationResearchResourcesRoleService delivery modelServicesSiteSouth AfricaSouth AfricanSystemTestingTimeTravelUninsuredWait Timeantenatalantiretroviral therapybaseclinical practicecohortcommunity based servicecostdensitydesignexpectationflexibilityfollow-uphome based serviceimplementation scienceimprovedinnovationinterestpreventprogramsprospectiverandomized trialscale upservice deliveryservice providerstransmission processuptakevirology
项目摘要
Project Summary
Achieving the UNAIDS 90-90-90 target by 2020 in sub-Saharan Africa will require innovative solutions to meet
the increasing demands placed on public health care facilities. With ART coverage in sub-Saharan Africa
hovering around 50%, health systems face the dual challenge of increasing HIV testing and ART enrollment for
those not yet in care and continuing to provide treatment to the millions of people already on ART. Community-
based ART delivery is a potential strategy for maintaining long-term virologic suppression and retention in HIV
care. South Africa’s new Central Chronic Medicine Dispensing and Distribution (CCMDD) program allows
clinically stable patients to choose from a list of community pick-up points (e.g., private pharmacies, schools,
churches) to access ART and therefore has the potential to offer more convenient services to patients and to
decompress health facilities. The current proposal leverages this national policy change to assess the impact
of this large scale service delivery intervention at the patient-, clinic-, and community-level over time in the
high-density settlement of Umlazi in Durban, South Africa. Using a mixed-methods approach that incorporates
the Practical, Robust Implementation and Sustainability Model (PRISM), we will comprehensively evaluate the
impact of CCMDD at all 10 public sector clinics in Umlazi through the following specific aims:
1) To prospectively assess patient uptake of CCMDD and patient factors associated with favorable early
clinical outcomes for CCMDD enrollees and to compare outcomes with non-enrollees; 2) To evaluate
facilitators of and barriers to adoption of CCMDD by patients, clinic staff, and administrators using qualitative
methods, and 3) To evaluate virologic suppression over time across all 10 public sector clinics in Umlazi using
programmatic electronic health record data.
This proposal is motivated by PA-17-182 to better understand system-level interventions using implementation
science, which may increase the number of people consistently engaged in HIV care. We have played a major
role for over a decade implementing and evaluating interventions along the HIV care continuum in South Africa
and are well-positioned to evaluate the impact of this important policy change. Our results will inform clinical
leaders and policymakers in high HIV prevalence settings developing community ART delivery systems that
will enable life-long therapy for millions of people living with HIV. This research has the potential to change
clinical practice throughout sub-Saharan Africa, where innovative and efficient approaches to long-term
community-based HIV treatment delivery are urgently needed.
项目摘要
到2020年在撒哈拉以南非洲实现联合国艾滋病规划署的90-90-90目标将需要创新的解决方案来实现
日益增长的需求对公共卫生保健设施提出了要求。在撒哈拉以南非洲地区进行ART报道
在50%左右徘徊,卫生系统面临着增加艾滋病毒检测和抗逆转录病毒治疗的双重挑战
那些尚未接受治疗的人,并继续为数百万已经接受抗逆转录病毒治疗的人提供治疗。社区-
基于ART的给药是维持HIV病毒长期抑制和滞留的潜在策略
关心。南非新的中央慢性药物分发和分发(CCMDD)计划允许
临床稳定的患者可以从社区接待点列表中选择(例如,私人药房,学校,
教堂)获得艺术,因此有可能为患者提供更方便的服务
为卫生设施减压。目前的提案利用这一国家政策变化来评估影响
随着时间的推移,这种在患者、诊所和社区层面的大规模服务提供干预
南非德班的乌姆拉齐高密度聚居地。使用结合了以下内容的混合方法
实用、稳健的实施和可持续发展模型(PRISM),我们将全面评估
CCMDD通过以下具体目标对乌姆拉齐所有10个公共部门诊所产生影响:
1)前瞻性地评估患者对CCMDD的摄取和与有利早期相关的患者因素
CCMDD参与者的临床结果并与非参与者的结果进行比较;2)评估
患者、诊所工作人员和管理人员使用定性方法采用CCMDD的促进者和障碍
方法,以及3)评估乌姆拉齐所有10家公共部门诊所随时间的病毒学抑制情况
程序化电子健康记录数据。
这项建议是由PA-17-182推动的,目的是更好地了解使用实施的系统级干预
科学,这可能会增加持续从事艾滋病毒护理的人数。我们打了一场大满贯
十多年来在南非实施和评估艾滋病毒护理连续干预措施的作用
并处于有利地位,可以评估这一重要政策变化的影响。我们的结果将通知临床
在艾滋病毒高流行环境中开发社区ART交付系统的领导人和政策制定者
将使数百万艾滋病毒携带者能够接受终身治疗。这项研究有可能改变
整个撒哈拉以南非洲的临床实践,在那里创新和有效地治疗长期
迫切需要以社区为基础的艾滋病毒治疗服务。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Ingrid Valerie Bassett其他文献
Ingrid Valerie Bassett的其他文献
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{{ truncateString('Ingrid Valerie Bassett', 18)}}的其他基金
Mentoring in patient-oriented research on HIV and global health
指导以患者为中心的艾滋病毒和全球健康研究
- 批准号:
9889026 - 财政年份:2019
- 资助金额:
$ 67.63万 - 项目类别:
Mentoring in patient-oriented research on HIV and global health
指导以患者为中心的艾滋病毒和全球健康研究
- 批准号:
9790038 - 财政年份:2019
- 资助金额:
$ 67.63万 - 项目类别:
Mentoring in patient-oriented research on HIV and global health
指导以患者为中心的艾滋病毒和全球健康研究
- 批准号:
10338169 - 财政年份:2019
- 资助金额:
$ 67.63万 - 项目类别:
Mentoring in patient-oriented research on HIV and global health
指导以患者为中心的艾滋病毒和全球健康研究
- 批准号:
10570265 - 财政年份:2019
- 资助金额:
$ 67.63万 - 项目类别:
South Africa's new Central Chronic Medicine Dispensing and Distribution program: assessing the clinic, patient, and community impact
南非新的中央慢性药物配发和分配计划:评估诊所、患者和社区的影响
- 批准号:
10194606 - 财政年份:2018
- 资助金额:
$ 67.63万 - 项目类别:
South Africa's new Central Chronic Medicine Dispensing and Distribution program: assessing the clinic, patient, and community impact
南非新的中央慢性药物配发和分配计划:评估诊所、患者和社区的影响
- 批准号:
10413904 - 财政年份:2018
- 资助金额:
$ 67.63万 - 项目类别:
What happens after diagnosis: Characterizing long-term HIV care trajectories and mortality in South Africa
诊断后会发生什么:描述南非长期艾滋病毒护理轨迹和死亡率
- 批准号:
9140315 - 财政年份:2016
- 资助金额:
$ 67.63万 - 项目类别:
Test and Treat TB: A Proof of Concept Trial in South Africa
测试和治疗结核病:南非的概念验证试验
- 批准号:
8739080 - 财政年份:2014
- 资助金额:
$ 67.63万 - 项目类别:
Test and Treat TB: A Proof of Concept Trial in South Africa
测试和治疗结核病:南非的概念验证试验
- 批准号:
8887097 - 财政年份:2014
- 资助金额:
$ 67.63万 - 项目类别:
Linkage & Retention: A Randomized Trial to Optimize HIV/TB Care in South Africa
连锁
- 批准号:
7838990 - 财政年份:2010
- 资助金额:
$ 67.63万 - 项目类别:
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