Major differences in organization and availability of health care and medicines for HIV/TB coinfected patients across Europe

Medientyp: E-Artikel
Titel: Major differences in organization and availability of health care and medicines for HIV/TB coinfected patients across Europe
Beteiligte: Mansfeld, M; Skrahina, A; Shepherd, L; Schultze, A; Panteleev, AM; Miller, RF; Miro, JM; Zeltina, I; Tetradov, S; Furrer, H; Kirk, O; Grzeszczuk, A; Bolokadze, N; Matteelli, A; Post, FA; Lundgren, JD; Mocroft, A; Efsen, AMW; Podlekareva, DN
Erschienen: Wiley, 2015
Erschienen in: HIV Medicine, 16 (2015) 9, Seite 544-552
Sprache: Englisch
DOI: 10.1111/hiv.12256
ISSN: 1468-1293; 1464-2662
Schlagwörter: Pharmacology (medical) ; Infectious Diseases ; Health Policy
Entstehung:
Anmerkungen:
Beschreibung: <jats:sec><jats:title>Objectives</jats:title><jats:p>The aim of the study was to investigate the organization and delivery of <jats:styled-content style="fixed-case">HIV</jats:styled-content> and tuberculosis (<jats:styled-content style="fixed-case">TB</jats:styled-content>) health care and to analyse potential differences between treatment centres in Eastern (<jats:styled-content style="fixed-case">EE</jats:styled-content>) and Western Europe (<jats:styled-content style="fixed-case">WE</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Thirty‐eight <jats:styled-content style="fixed-case">E</jats:styled-content>uropean <jats:styled-content style="fixed-case">HIV</jats:styled-content> and <jats:styled-content style="fixed-case">TB</jats:styled-content> treatment centres participating in the <jats:styled-content style="fixed-case">TB</jats:styled-content>:<jats:styled-content style="fixed-case">HIV</jats:styled-content> study within <jats:styled-content style="fixed-case">EuroCoord</jats:styled-content> completed a survey on health care management for coinfected patients in 2013 (<jats:styled-content style="fixed-case">EE</jats:styled-content>: 17 respondents; <jats:styled-content style="fixed-case">WE</jats:styled-content>:21; 76% of all <jats:styled-content style="fixed-case">TB</jats:styled-content>:<jats:styled-content style="fixed-case">HIV</jats:styled-content> centres). Descriptive statistics were obtained for regional comparisons. The reported data on health care strategies were compared with actual clinical practice at patient level via data derived from the <jats:styled-content style="fixed-case">TB</jats:styled-content>:<jats:styled-content style="fixed-case">HIV</jats:styled-content> study.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Respondent centres in <jats:styled-content style="fixed-case">EE</jats:styled-content> comprised: <jats:styled-content style="fixed-case">B</jats:styled-content>elarus (<jats:italic>n</jats:italic> = 3), <jats:styled-content style="fixed-case">E</jats:styled-content>stonia (1), <jats:styled-content style="fixed-case">G</jats:styled-content>eorgia (1), <jats:styled-content style="fixed-case">L</jats:styled-content>atvia (1), <jats:styled-content style="fixed-case">L</jats:styled-content>ithuania (1), <jats:styled-content style="fixed-case">P</jats:styled-content>oland (4), <jats:styled-content style="fixed-case">R</jats:styled-content>omania (1), the <jats:styled-content style="fixed-case">R</jats:styled-content>ussian <jats:styled-content style="fixed-case">F</jats:styled-content>ederation (4) and <jats:styled-content style="fixed-case">U</jats:styled-content>kraine (1); those in <jats:styled-content style="fixed-case">WE</jats:styled-content> comprised: <jats:styled-content style="fixed-case">B</jats:styled-content>elgium (1), <jats:styled-content style="fixed-case">D</jats:styled-content>enmark (1), <jats:styled-content style="fixed-case">F</jats:styled-content>rance (1), <jats:styled-content style="fixed-case">I</jats:styled-content>taly (7), <jats:styled-content style="fixed-case">S</jats:styled-content>pain (2), <jats:styled-content style="fixed-case">S</jats:styled-content>witzerland (1) and <jats:styled-content style="fixed-case">UK</jats:styled-content> (8). Compared with WE, treatment of HIV and TB in <jats:styled-content style="fixed-case">EE</jats:styled-content> are less often located at the same site (47% in <jats:styled-content style="fixed-case">EE</jats:styled-content> versus 100% in WE; <jats:italic>P</jats:italic> < 0.001) and less often provided by the same doctors (41% versus 90%, respectively; <jats:italic>P</jats:italic> = 0.002), whereas regular screening of <jats:styled-content style="fixed-case">HIV</jats:styled-content>‐infected patients for <jats:styled-content style="fixed-case">TB</jats:styled-content> (80% versus 40%, respectively; <jats:italic>P</jats:italic> = 0.037) and directly observed treatment (88% versus 20%, respectively; <jats:italic>P</jats:italic> < 0.001) were more common in <jats:styled-content style="fixed-case">EE</jats:styled-content>. The reported availability of rifabutin and second‐ and third‐line anti‐<jats:styled-content style="fixed-case">TB</jats:styled-content> drugs was lower, and opioid substitution therapy (<jats:styled-content style="fixed-case">OST</jats:styled-content>) was available at fewer centres in <jats:styled-content style="fixed-case">EE</jats:styled-content> compared with <jats:styled-content style="fixed-case">WE</jats:styled-content> (53% versus 100%, respectively; <jats:italic>P</jats:italic> < 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Major differences exist between <jats:styled-content style="fixed-case">EE</jats:styled-content> and <jats:styled-content style="fixed-case">WE</jats:styled-content> in relation to the organization and delivery of health care for <jats:styled-content style="fixed-case">HIV</jats:styled-content>/<jats:styled-content style="fixed-case">TB</jats:styled-content>‐coinfected patients and the availability of anti‐<jats:styled-content style="fixed-case">TB</jats:styled-content> drugs and <jats:styled-content style="fixed-case">OST</jats:styled-content>. Significant discrepancies between reported and actual clinical practices were found in <jats:styled-content style="fixed-case">EE</jats:styled-content>.</jats:p></jats:sec>
Zugangsstatus: Freier Zugang

Nur in Feld suchen:

Zuletzt gesuchte Begriffe: