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9th Annual Conference Of The British HIV Association [BHIVA]24 – 26 April 2003, University of Manchester
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[AUTHOR(S):] S Dave1, K Miles1,2, DE Mercy2, C Griffiths2 and SG Edwards1
1 Mortimer Market Centre and 2 Camden PCT, Department of STDs, Royal Free and University College Medical School, London, UK
BHIVA Conf 2003 Apr 24-26;9:O25
BACKGROUND: Improved survival and continuing HIV incidence have led to significant changes in the needs of patients attending for routine HIV outpatient care. As the costs of antiretroviral treatment escalate, we decided to review the doctor–patient caseload.
METHODS: Data were collected prospectively on all patients who booked appointments for routine HIV outpatient care between 24 June 2002 and 17 July 2002. Data collected included patient attendance, duration of appointment, CD4 count, HIV viral load, antiretroviral therapy, clinical status and grade of doctor seeing the patient.
RESULTS: Data collection forms were completed for 431/433 consecutive appointments. The non-attendance rate was 18% (79/431). The median CD4 count and viral load were 350 cells/µl (range 10-1490) and 600 copies/ml (range <50 to 3 million), respectively. Consultant staff saw 66% of the patients. A quarter of consultations were used by patients requiring close monitoring of starting/changing antiretroviral therapy. Almost half (49%; 173/352) of the patients seen were defined by their physician as being asymptomatic with respect to HIV infection. These patients either had no new medical, psychological or social problems (63%; 108/173), had primary care-related problems (21%; 36/173) or had non-acute problems requiring discussion with an HIV-trained professional (e.g. lipodystrophy, high lipids, viral blips).
CONCLUSIONS: A high proportion of patients attending routine HIV outpatient clinics have needs that could be met by other healthcare professionals. With an ever-increasing demand on services, there is a need to develop cost-effective models of care that match the patient caseload with appropriate professional expertise without reducing the quality of care.
PRESENTING AUTHOR: K Miles
030424
O25
Copyright © 2003 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD