Differences in integrated assessment and management of non-communicable diseases (NCDs) for people with HIV across the WHO European region

. 2024 Jun ; 25 (6) : 700-710. [epub] 20240215

Jazyk angličtina Země Anglie, Velká Británie Médium print-electronic

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/pmid38361216

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.

AP HP Necker Hospital Infectious Diseases Department Necker Pasteur Infectiology Center IHU Imagine Université de Paris NSERM U1016 Institut Cochin CNRS UMR8104 Paris France

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

Department of Respiratory Medicine and Infectious Diseases Copenhagen University Hospital Bispebjerg Copenhagen Denmark

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

Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases and Department for Infectious Diseases Parasitology and Tropical Medicine Medical University of Sofia Sofia Bulgaria

Tel Aviv Sourasky Medical Center Tel Aviv Israel

University Clinic for Infectious Diseases and Febrile Conditions Skopje North Macedonia

Western General Hospital Edinburgh UK

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