Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, China
Abstract Background This paper introduces a comprehensive case management model uniting doctors, nurses, and non-governmental organizations (NGOs) in order to shorten the time from HIV diagnosis to initiation of antiviral therapy, improve patients’ adherence, and ameliorate antiretroviral treatment...
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doaj-605930ffea3948f6b52f8d9816b6685e2020-11-25T02:48:09ZengBMCBMC Infectious Diseases1471-23342020-07-012011910.1186/s12879-020-05219-9Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, ChinaLili Dai0Xiaochun Yu1Ying Shao2Yali Wang3Zaicun Li4Jiangzhu Ye5Shaoli Bai6Xiaoling Guo7Jianyun Wang8Bin Su9Taiyi Jiang10Tong Zhang11Hao Wu12Sarah Robbins Scott13An Liu14Lijun Sun15Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical UniversitySchool of Public Health, Anhui Medical UniversityCenter for Infectious Diseases, Beijing Youan Hospital, Capital Medical UniversityCenter for Infectious Diseases, Beijing Youan Hospital, Capital Medical UniversityCenter for Infectious Diseases, Beijing Youan Hospital, Capital Medical UniversityCenter for Infectious Diseases, Beijing Youan Hospital, Capital Medical UniversityLanzhou Municipality Pulmonary HospitalLanzhou Municipality Pulmonary HospitalLanzhou Municipality Pulmonary HospitalCenter for Infectious Diseases, Beijing Youan Hospital, Capital Medical UniversityCenter for Infectious Diseases, Beijing Youan Hospital, Capital Medical UniversityCenter for Infectious Diseases, Beijing Youan Hospital, Capital Medical UniversityCenter for Infectious Diseases, Beijing Youan Hospital, Capital Medical UniversityThe National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and PreventionCenter for Infectious Diseases, Beijing Youan Hospital, Capital Medical UniversityCenter for Infectious Diseases, Beijing Youan Hospital, Capital Medical UniversityAbstract Background This paper introduces a comprehensive case management model uniting doctors, nurses, and non-governmental organizations (NGOs) in order to shorten the time from HIV diagnosis to initiation of antiviral therapy, improve patients’ adherence, and ameliorate antiretroviral treatment (ART)-related outcomes. Methods All newly diagnosed human immunodeficiency virus (HIV) cases at Beijing YouAn Hospital from January 2012 to December 2013 were selected as the control group, while all newly diagnosed HIV-infected patients from January 2015 to December 2016 were selected as the intervention group, receiving the comprehensive case management model. Results 4906 patients were enrolled, of which 1549 were in the control group and 3357 in the intervention group. The median time from confirming HIV infection to ART initiation in the intervention group was 35 (18–133) days, much shorter than the control group (56 (26–253) days, P < 0.001). Participants in the intervention group had better ART adherence compared to those in the control group (intervention: 95.3%; control: 89.2%; p < 0.001). During the 2 years’ follow-up, those receiving case management were at decreased odds of experiencing virological failure (OR: 0.27, 95%CI: 0.17–0.42, P < 0.001). Observed mortality was 0.4 deaths per 100 patient-years of follow-up for patients in the control group compared with 0.2 deaths per 100 patient-years of follow-up in the intervention group. Conclusions People living with HIV engaged in the comprehensive case management model were more likely to initiate ART sooner and maintained better treatment compliance and improved clinical outcomes compared to those who received routine care. A comprehensive case management program could be implemented in hospitals across China in order to reduce the HIV disease burden in the country.http://link.springer.com/article/10.1186/s12879-020-05219-9Case managementHIVVirologic failureRetention rate |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lili Dai Xiaochun Yu Ying Shao Yali Wang Zaicun Li Jiangzhu Ye Shaoli Bai Xiaoling Guo Jianyun Wang Bin Su Taiyi Jiang Tong Zhang Hao Wu Sarah Robbins Scott An Liu Lijun Sun |
spellingShingle |
Lili Dai Xiaochun Yu Ying Shao Yali Wang Zaicun Li Jiangzhu Ye Shaoli Bai Xiaoling Guo Jianyun Wang Bin Su Taiyi Jiang Tong Zhang Hao Wu Sarah Robbins Scott An Liu Lijun Sun Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, China BMC Infectious Diseases Case management HIV Virologic failure Retention rate |
author_facet |
Lili Dai Xiaochun Yu Ying Shao Yali Wang Zaicun Li Jiangzhu Ye Shaoli Bai Xiaoling Guo Jianyun Wang Bin Su Taiyi Jiang Tong Zhang Hao Wu Sarah Robbins Scott An Liu Lijun Sun |
author_sort |
Lili Dai |
title |
Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, China |
title_short |
Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, China |
title_full |
Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, China |
title_fullStr |
Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, China |
title_full_unstemmed |
Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, China |
title_sort |
effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in beijing, china |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2020-07-01 |
description |
Abstract Background This paper introduces a comprehensive case management model uniting doctors, nurses, and non-governmental organizations (NGOs) in order to shorten the time from HIV diagnosis to initiation of antiviral therapy, improve patients’ adherence, and ameliorate antiretroviral treatment (ART)-related outcomes. Methods All newly diagnosed human immunodeficiency virus (HIV) cases at Beijing YouAn Hospital from January 2012 to December 2013 were selected as the control group, while all newly diagnosed HIV-infected patients from January 2015 to December 2016 were selected as the intervention group, receiving the comprehensive case management model. Results 4906 patients were enrolled, of which 1549 were in the control group and 3357 in the intervention group. The median time from confirming HIV infection to ART initiation in the intervention group was 35 (18–133) days, much shorter than the control group (56 (26–253) days, P < 0.001). Participants in the intervention group had better ART adherence compared to those in the control group (intervention: 95.3%; control: 89.2%; p < 0.001). During the 2 years’ follow-up, those receiving case management were at decreased odds of experiencing virological failure (OR: 0.27, 95%CI: 0.17–0.42, P < 0.001). Observed mortality was 0.4 deaths per 100 patient-years of follow-up for patients in the control group compared with 0.2 deaths per 100 patient-years of follow-up in the intervention group. Conclusions People living with HIV engaged in the comprehensive case management model were more likely to initiate ART sooner and maintained better treatment compliance and improved clinical outcomes compared to those who received routine care. A comprehensive case management program could be implemented in hospitals across China in order to reduce the HIV disease burden in the country. |
topic |
Case management HIV Virologic failure Retention rate |
url |
http://link.springer.com/article/10.1186/s12879-020-05219-9 |
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