TITLE:
Does Quality of Care Differ When HIV Patients Are Treated by Non-Specialist and Specialist HIV Healthcare Providers in Developed Countries? A Systematic Narrative Review
AUTHORS:
Bossakara Sokhom, Emmanuel Okpo, Ivan Tonna, Amudha Poobalan
KEYWORDS:
HIV/AIDS, Healthcare Providers, Quality of Care, Developed Countries, Systematic Review
JOURNAL NAME:
World Journal of AIDS,
Vol.5 No.3,
August
28,
2015
ABSTRACT: Introduction: In developed countries, HIV
care is mostly provided by trained specialist healthcare professionals. Due to
the increasing demand for HIV care, pressure on healthcare providers to reduce
cost and the current global economic constraints, many developed countries are
searching for alternative HIV care models. This review aims to consider whether
HIV treatment and care can be provided as effectively and safely by doctors and
nurses with no HIV-specialist training compared to those with HIV-specialist
training. Methods: Three electronic bibliographic databases MEDLINE, EMBASE and
the Cochrane Library were searched for studies conducted between January 1996
and March 2015. Manual searches of reference lists of all relevant reports
retrieved from the electronic databases were conducted. All comparative studies
examining the quality of HIV care provided by different types of healthcare
providers in developed countries were included. Results: Nine observational
studies involving 27,015 patients were included in the review. Eight studies
were conducted in the USA and one study in Switzerland. Healthcare providers
with HIV-related expertise and or training and those without HIV-related
expertise or training who collaborated with providers with HIV-related
expertise and or training outperformed other healthcare providers in many
virological, immunological and ART-related outcomes. Conclusion: This review
found moderate quality evidence that HIV care can be provided effectively by
non-HIV specialists if they have access to HIV specialists or experts for
advice and support.