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Differences in integrated assessment and management of non-communicable diseases (NCDs) for people with HIV across the WHO European region
C. Kraef, S. Singh, O. Fursa, A. Abutidze, N. Rukhadze, V. Mulabdic, N. Yancheva, M. Mehmeti, T. Balayan, A. Harxhi, J. Trajanovska, C. Mackintosh, C. Duvivier, M. Beniowski, D. Jilich, DH. Reikvam, L. Tau, D. Podlekareva, L. Ryom, L. Peters, J....
Language English Country England, Great Britain
Document type Journal Article
PubMed
38361216
DOI
10.1111/hiv.13619
Knihovny.cz E-resources
- MeSH
- Renal Insufficiency, Chronic therapy diagnosis epidemiology MeSH
- Adult MeSH
- HIV Infections * diagnosis therapy complications epidemiology MeSH
- Humans MeSH
- Noncommunicable Diseases * therapy epidemiology MeSH
- Surveys and Questionnaires MeSH
- World Health Organization MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
OBJECTIVES: We aimed to assess the extent of integration of non-communicable disease (NCD) assessment and management in HIV clinics across Europe. METHODS: A structured electronic questionnaire with 41 multiple-choice and rating-scale questions assessing NCD assessment and management was sent to 88 HIV clinics across the WHO European Region during March-May 2023. One response per clinic was collected. RESULTS: In all, 51 clinics from 34 countries with >100 000 people with HIV under regular follow-up responded. Thirty-seven clinics (72.6%) reported shared NCD care responsibility with the general practitioner. Systematic assessment for NCDs and integration of NCD management were common overall [median agreement 80%, interquartile range (IQR): 55-95%; and 70%, IQR: 50-88%, respectively] but were lowest in central eastern and eastern Europe. Chronic kidney disease (median agreement 96%, IQR: 85-100%) and metabolic disorders (90%, IQR: 75-100%) were regularly assessed, while mental health (72%, IQR: 63-85%) and pulmonary diseases (52%, IQR: 40-75%) were less systematically assessed. Some essential diagnostic tests such as glycated haemoglobin (HbA1c) for diabetes (n = 38/51, 74.5%), proteinuria for kidney disease (n = 30/51, 58.8%) and spirometry for lung disease (n = 11/51, 21.6%) were only employed by a proportion of clinics. The most frequent barriers for integrating NCD care were the lack of healthcare workers (n = 17/51, 33.3%) and lack of time during outpatient visits (n = 12/51, 23.5%). CONCLUSION: Most HIV clinics in Europe systematically assess and manage NCDs. People with HIV appear to be screened more frequently than the general population at the same age. There are, however, larger gaps among eastern European clinics in general and for clinics in all regions related to mental health, pulmonary diseases and the employment of some essential diagnostic tests.
Charles University Prague and Na Bulovce Hospital Prague Czech Republic
CHIP RIgshospitalet University of Copenhagen Copenhagen Denmark
Clinic for Infectious Diseases University Clinical Center Sarajevo Sarajevo Bosnia and Herzegovina
Department of Infectious Diseases Hvidovre University Hospital Hvidovre Denmark
Department of Infectious Diseases Oslo University Hospital Oslo Norway
Department of Infectious Diseases Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
Department of Infectious Diseases University Clinical Centre Pristina Kosovo
Diagnostics and Therapy for AIDS Specialistic Hospital Chorzów Poland
Hospital for Infectious Diseases Medical University of Warsaw Warsaw Poland
Infectious Disease Service HIV Ambulatory Clinic Tirana Albania
Infectious Diseases AIDS and Clinical Immunology Research Center Tbilisi Georgia
Institut Pasteur Medical Center of Institut Pasteur Necker Pasteur Infectiology Center Paris France
National Center for Disease Control and Prevention Yerevan Armenia
Tel Aviv Sourasky Medical Center Tel Aviv Israel
University Clinic for Infectious Diseases and Febrile Conditions Skopje North Macedonia
References provided by Crossref.org
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