Treatment outcomes among adults with HIV/non-communicable disease multimorbidity attending integrated care clubs in Cape Town, South Africa
| dc.contributor.author | Gausi, Blessings | |
| dc.contributor.author | Berkowitz, Natacha | |
| dc.contributor.author | Jacob, Nisha | |
| dc.contributor.author | Oni, Tolu | |
| dc.date.accessioned | 2021-10-26T08:56:30Z | |
| dc.date.available | 2021-10-26T08:56:30Z | |
| dc.date.issued | 2021-10-14 | |
| dc.date.updated | 2021-10-17T03:13:05Z | |
| dc.description.abstract | Background The growing burden of the HIV and non-communicable disease (NCD) syndemic in Sub- Saharan Africa has necessitated introduction of integrated models of care in order to leverage existing HIV care infrastructure for NCDs. However, there is paucity of literature on treatment outcomes for multimorbid patients attending integrated care. We describe 12-month treatment outcomes among multimorbid patients attending integrated antiretroviral treatment (ART) and NCD clubs in Cape Town, South Africa. Methods As part of an integrated clubs (IC) model pilot implemented in 2016 by the local government at two primary health care clinics in Cape Town, we identified all multimorbid patients who were enrolled for IC for at least 12 months by August 2017. Mean adherence percentages (using proxy of medication collection and attendance of club visits) and optimal disease control (defined as the proportion of participants achieving optimal blood pressure, glycosylated haemoglobin control and HIV viral load suppression where appropriate) were calculated at 12 months before, at the point of IC enrolment and 12 months after IC enrolment. Predictors of NCD control 12 months post IC enrolment were investigated using multivariable logistic regression. Results As of 31 August 2017, 247 HIV-infected patients in total had been enrolled into IC for at least 12 months. Of these, 221 (89.5%) had hypertension, 4 (1.6%) had diabetes mellitus and 22 (8.9%) had both diseases. Adherence was maintained before and after IC enrolment with mean adherence percentages of 92.2% and 94.2% respectively. HIV viral suppression rates were 98.6%, 99.5% and 99.4% at the three time points respectively. Retention in care was high with 6.9% lost to follow up at 12 months post IC enrolment. Across the 3 time-points, optimal blood pressure control was achieved in 43.1%, 58.9% and 49.4% of participants while optimal glycaemic control was achieved in 47.4%, 87.5% and 53.3% of participants with diabetes respectively. Multivariable logistic analyses showed no independent variables significantly associated with NCD control. Conclusion Multimorbid adults living with HIV achieved high levels of HIV control in integrated HIV and NCD clubs. However, intensified interventions are needed to maintain NCD control in the long term. | en_US |
| dc.identifier.apacitation | Gausi, B., Berkowitz, N., Jacob, N., & Oni, T. (2021). Treatment outcomes among adults with HIV/non-communicable disease multimorbidity attending integrated care clubs in Cape Town, South Africa. <i>AIDS Research and Therapy</i>, 18(1), 72. http://hdl.handle.net/11427/35291 | en_ZA |
| dc.identifier.chicagocitation | Gausi, Blessings, Natacha Berkowitz, Nisha Jacob, and Tolu Oni "Treatment outcomes among adults with HIV/non-communicable disease multimorbidity attending integrated care clubs in Cape Town, South Africa." <i>AIDS Research and Therapy</i> 18, 1. (2021): 72. http://hdl.handle.net/11427/35291 | en_ZA |
| dc.identifier.citation | Gausi, B., Berkowitz, N., Jacob, N. & Oni, T. 2021. Treatment outcomes among adults with HIV/non-communicable disease multimorbidity attending integrated care clubs in Cape Town, South Africa. <i>AIDS Research and Therapy.</i> 18(1):72. http://hdl.handle.net/11427/35291 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Gausi, Blessings AU - Berkowitz, Natacha AU - Jacob, Nisha AU - Oni, Tolu AB - Background The growing burden of the HIV and non-communicable disease (NCD) syndemic in Sub- Saharan Africa has necessitated introduction of integrated models of care in order to leverage existing HIV care infrastructure for NCDs. However, there is paucity of literature on treatment outcomes for multimorbid patients attending integrated care. We describe 12-month treatment outcomes among multimorbid patients attending integrated antiretroviral treatment (ART) and NCD clubs in Cape Town, South Africa. Methods As part of an integrated clubs (IC) model pilot implemented in 2016 by the local government at two primary health care clinics in Cape Town, we identified all multimorbid patients who were enrolled for IC for at least 12 months by August 2017. Mean adherence percentages (using proxy of medication collection and attendance of club visits) and optimal disease control (defined as the proportion of participants achieving optimal blood pressure, glycosylated haemoglobin control and HIV viral load suppression where appropriate) were calculated at 12 months before, at the point of IC enrolment and 12 months after IC enrolment. Predictors of NCD control 12 months post IC enrolment were investigated using multivariable logistic regression. Results As of 31 August 2017, 247 HIV-infected patients in total had been enrolled into IC for at least 12 months. Of these, 221 (89.5%) had hypertension, 4 (1.6%) had diabetes mellitus and 22 (8.9%) had both diseases. Adherence was maintained before and after IC enrolment with mean adherence percentages of 92.2% and 94.2% respectively. HIV viral suppression rates were 98.6%, 99.5% and 99.4% at the three time points respectively. Retention in care was high with 6.9% lost to follow up at 12 months post IC enrolment. Across the 3 time-points, optimal blood pressure control was achieved in 43.1%, 58.9% and 49.4% of participants while optimal glycaemic control was achieved in 47.4%, 87.5% and 53.3% of participants with diabetes respectively. Multivariable logistic analyses showed no independent variables significantly associated with NCD control. Conclusion Multimorbid adults living with HIV achieved high levels of HIV control in integrated HIV and NCD clubs. However, intensified interventions are needed to maintain NCD control in the long term. DA - 2021-10-14 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - AIDS Research and Therapy KW - HIV/AIDS KW - Hypertension KW - Diabetes mellitus KW - Non-communicable diseases KW - Multimorbidity KW - Integrated care KW - Adherence clubs KW - South Africa LK - https://open.uct.ac.za PY - 2021 T1 - Treatment outcomes among adults with HIV/non-communicable disease multimorbidity attending integrated care clubs in Cape Town, South Africa TI - Treatment outcomes among adults with HIV/non-communicable disease multimorbidity attending integrated care clubs in Cape Town, South Africa UR - http://hdl.handle.net/11427/35291 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s12981-021-00387-3 | |
| dc.identifier.uri | http://hdl.handle.net/11427/35291 | |
| dc.identifier.vancouvercitation | Gausi B, Berkowitz N, Jacob N, Oni T. Treatment outcomes among adults with HIV/non-communicable disease multimorbidity attending integrated care clubs in Cape Town, South Africa. AIDS Research and Therapy. 2021;18(1):72. http://hdl.handle.net/11427/35291. | en_ZA |
| dc.language.iso | en | en_US |
| dc.language.rfc3066 | en | |
| dc.publisher.department | Department of Public Health and Family Medicine | en_US |
| dc.publisher.faculty | Faculty of Health Sciences | en_US |
| dc.rights.holder | The Author(s) | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_US |
| dc.source | AIDS Research and Therapy | en_US |
| dc.source.journalissue | 1 | en_US |
| dc.source.journalvolume | 18 | en_US |
| dc.source.pagination | 72 | en_US |
| dc.source.uri | https://aidsrestherapy.biomedcentral.com/ | |
| dc.subject | HIV/AIDS | en_US |
| dc.subject | Hypertension | en_US |
| dc.subject | Diabetes mellitus | en_US |
| dc.subject | Non-communicable diseases | en_US |
| dc.subject | Multimorbidity | en_US |
| dc.subject | Integrated care | en_US |
| dc.subject | Adherence clubs | en_US |
| dc.subject | South Africa | en_US |
| dc.title | Treatment outcomes among adults with HIV/non-communicable disease multimorbidity attending integrated care clubs in Cape Town, South Africa | en_US |
| dc.type | Journal Article | en_US |