Article type
Year
Abstract
Background: There are several HIV guidelines, based on the age group and clinical condition of the patient. After the START study, the primary health care approach to HIV care is a new challenge, especially for those patients who are asymptomatic and have a CD4 count higher than 350, and in settings where there is a high incidence rate of HIV. There is a need to identify new strategies.
Objectives: To identify the importance of implementing an academic detailing (AD) strategy for the clinical application of an HIV guideline in primary care.
Methods: This study is based on an extensive literature review of the use of AD for HIV programmes in low- and middle-income countries (LMIC). We describe the steps used to deliver an HIV programme.
Results: There are seven steps in the programme: 1) identification of the difficulties in adherence to the protocol using a questionnaire; 2) elaboration of a manual for rapid consultation on the main evidence and development of the object of learning based on the evidence related to the guideline; 3) training the facilitators responsible for educational outreach; 4) defining the goal in order to begin anti-retroviral therapy as soon as possible in patients who have a CD4 count of 350 or more; 5) prescriber visiting for AD once a month for three months; 6) virtual assistance if there is any doubt and 7) follow-up of the results.
Conclusions: In South America, there are few publications on AD but it is regarded as a very low cost strategy for implementation of a guideline. This could overcome gaps in strategies for the implementation of new guidelines for HIV in primary health care.
Patient or healthcare consumer involvement: This study has been approved by the Ethical Committee of the University: a representative of patients is one of the members of this committee.
Objectives: To identify the importance of implementing an academic detailing (AD) strategy for the clinical application of an HIV guideline in primary care.
Methods: This study is based on an extensive literature review of the use of AD for HIV programmes in low- and middle-income countries (LMIC). We describe the steps used to deliver an HIV programme.
Results: There are seven steps in the programme: 1) identification of the difficulties in adherence to the protocol using a questionnaire; 2) elaboration of a manual for rapid consultation on the main evidence and development of the object of learning based on the evidence related to the guideline; 3) training the facilitators responsible for educational outreach; 4) defining the goal in order to begin anti-retroviral therapy as soon as possible in patients who have a CD4 count of 350 or more; 5) prescriber visiting for AD once a month for three months; 6) virtual assistance if there is any doubt and 7) follow-up of the results.
Conclusions: In South America, there are few publications on AD but it is regarded as a very low cost strategy for implementation of a guideline. This could overcome gaps in strategies for the implementation of new guidelines for HIV in primary health care.
Patient or healthcare consumer involvement: This study has been approved by the Ethical Committee of the University: a representative of patients is one of the members of this committee.