The effectiveness and cost implications of task-shifting in the delivery of antiretroviral therapy to HIV-infected patients: a systematic review.
Identifieur interne : 001791 ( Ncbi/Merge ); précédent : 001790; suivant : 001792The effectiveness and cost implications of task-shifting in the delivery of antiretroviral therapy to HIV-infected patients: a systematic review.
Auteurs : Noreen Dadirai Mdege [Royaume-Uni] ; Stanley Chindove ; Shehzad AliSource :
- Health policy and planning [ 1460-2237 ] ; 2013.
Descripteurs français
- KwdFr :
- Agents antiVIH (usage thérapeutique), Agents antiVIH (économie), Analyse coût-bénéfice, Coûts des soins de santé, Humains, Infections à VIH (traitement médicamenteux), Infections à VIH (économie), Numération des lymphocytes CD4, Observance du traitement médicamenteux, Prestations des soins de santé (), Prestations des soins de santé (organisation et administration), Prestations des soins de santé (économie), Résultat thérapeutique, Rôle de l'infirmier, Rôle médical.
- MESH :
- organisation et administration : Prestations des soins de santé.
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Agents antiVIH.
- économie : Agents antiVIH, Infections à VIH, Prestations des soins de santé.
- Analyse coût-bénéfice, Coûts des soins de santé, Humains, Numération des lymphocytes CD4, Observance du traitement médicamenteux, Prestations des soins de santé, Résultat thérapeutique, Rôle de l'infirmier, Rôle médical.
English descriptors
- KwdEn :
- Anti-HIV Agents (economics), Anti-HIV Agents (therapeutic use), CD4 Lymphocyte Count, Cost-Benefit Analysis, Delivery of Health Care (economics), Delivery of Health Care (methods), Delivery of Health Care (organization & administration), HIV Infections (drug therapy), HIV Infections (economics), Health Care Costs, Humans, Medication Adherence, Nurse's Role, Physician's Role, Treatment Outcome.
- MESH :
- chemical , economics : Anti-HIV Agents.
- chemical , therapeutic use : Anti-HIV Agents.
- drug therapy : HIV Infections.
- economics : Delivery of Health Care, HIV Infections.
- methods : Delivery of Health Care.
- organization & administration : Delivery of Health Care.
- CD4 Lymphocyte Count, Cost-Benefit Analysis, Health Care Costs, Humans, Medication Adherence, Nurse's Role, Physician's Role, Treatment Outcome.
Abstract
Human resource shortages are a challenge to the rollout of antiretroviral therapy (ART) for HIV-infected patients, particularly in sub-Saharan Africa. Task-shifting has been recommended as an approach to reduce the impact of human resource shortages. We conducted a systematic review of randomized controlled trials and quasi-experimental studies to assess the effectiveness of task-shifting, and its impact on costs of ART provision.
DOI: 10.1093/heapol/czs058
PubMed: 22738755
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médicamenteux)</term><term>Infections à VIH (économie)</term><term>Numération des lymphocytes CD4</term><term>Observance du traitement médicamenteux</term><term>Prestations des soins de santé ()</term><term>Prestations des soins de santé (organisation et administration)</term><term>Prestations des soins de santé (économie)</term><term>Résultat thérapeutique</term><term>Rôle de l'infirmier</term><term>Rôle médical</term></keywords><keywords scheme="MESH" type="chemical" qualifier="economics" xml:lang="en"><term>Anti-HIV Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-HIV Agents</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Delivery of Health Care</term><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Delivery of Health Care</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Prestations des soins de santé</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Delivery of Health Care</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Agents antiVIH</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Agents antiVIH</term><term>Infections à VIH</term><term>Prestations des soins de santé</term></keywords><keywords scheme="MESH" xml:lang="en"><term>CD4 Lymphocyte Count</term><term>Cost-Benefit Analysis</term><term>Health Care Costs</term><term>Humans</term><term>Medication Adherence</term><term>Nurse's Role</term><term>Physician's Role</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Analyse coût-bénéfice</term><term>Coûts des soins de santé</term><term>Humains</term><term>Numération des lymphocytes CD4</term><term>Observance du traitement médicamenteux</term><term>Prestations des soins de santé</term><term>Résultat thérapeutique</term><term>Rôle de l'infirmier</term><term>Rôle médical</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Human resource shortages are a challenge to the rollout of antiretroviral therapy (ART) for HIV-infected patients, particularly in sub-Saharan Africa. Task-shifting has been recommended as an approach to reduce the impact of human resource shortages. We conducted a systematic review of randomized controlled trials and quasi-experimental studies to assess the effectiveness of task-shifting, and its impact on costs of ART provision.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">22738755</PMID><DateCreated><Year>2013</Year><Month>05</Month><Day>06</Day></DateCreated><DateCompleted><Year>2014</Year><Month>01</Month><Day>27</Day></DateCompleted><DateRevised><Year>2013</Year><Month>05</Month><Day>06</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1460-2237</ISSN><JournalIssue CitedMedium="Internet"><Volume>28</Volume><Issue>3</Issue><PubDate><Year>2013</Year><Month>May</Month></PubDate></JournalIssue><Title>Health policy and planning</Title><ISOAbbreviation>Health Policy Plan</ISOAbbreviation></Journal><ArticleTitle>The effectiveness and cost implications of task-shifting in the delivery of antiretroviral therapy to HIV-infected patients: a systematic review.</ArticleTitle><Pagination><MedlinePgn>223-36</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/heapol/czs058</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Human resource shortages are a challenge to the rollout of antiretroviral therapy (ART) for HIV-infected patients, particularly in sub-Saharan Africa. Task-shifting has been recommended as an approach to reduce the impact of human resource shortages. We conducted a systematic review of randomized controlled trials and quasi-experimental studies to assess the effectiveness of task-shifting, and its impact on costs of ART provision.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We searched MEDLINE, EMBASE, PSYCINFO, Cochrane Library, Web of Knowledge and the Current Controlled Trials Register for articles published up to January 2011. We included studies evaluating any task-shifting model against any other intervention using any of the following outcomes: mortality (all causes); occurrence of new AIDS-defining illness; virological outcomes; CD4 cell count; adherence to ART medicines (e.g. self-report and pill counts); hospital admissions; clinic visits; toxicity or adverse events; quality of life indicators; costs and cost-effectiveness. We did not pool the results because of high levels of clinical heterogeneity.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">We identified six effectiveness studies including a total of 19 767 patients. Non-inferior patient outcomes were achieved with task-shifting from doctors to nurses, or from health care professionals to mid-level workers or lay health workers. However, most of the identified studies were underpowered to detect any difference. Three studies were identified on the cost implications of task-shifting. Task-shifting resulted in substantial cost and physician time savings.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The reviewed evidence suggests that task-shifting from doctors to nurses, or from health care professionals to lay health workers can potentially reduce costs of ART provision without compromising health outcomes for patients. Task-shifting is therefore a potentially effective and cost-effective approach to addressing the human resource limitations to ART rollout. However, most of the studies conducted were relatively small and more evidence is needed for each task-shifting model as it is currently limited.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mdege</LastName><ForeName>Noreen Dadirai</ForeName><Initials>ND</Initials><AffiliationInfo><Affiliation>Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK. noreen.mdege@york.ac.uk</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chindove</LastName><ForeName>Stanley</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Ali</LastName><ForeName>Shehzad</ForeName><Initials>S</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2012</Year><Month>06</Month><Day>26</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Health Policy Plan</MedlineTA><NlmUniqueID>8610614</NlmUniqueID><ISSNLinking>0268-1080</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019380">Anti-HIV Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>H</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D019380" MajorTopicYN="N">Anti-HIV Agents</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018791" MajorTopicYN="N">CD4 Lymphocyte Count</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003362" MajorTopicYN="N">Cost-Benefit Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003695" MajorTopicYN="N">Delivery of Health Care</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName><QualifierName UI="Q000458" MajorTopicYN="N">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015658" MajorTopicYN="N">HIV Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017048" MajorTopicYN="N">Health Care Costs</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055118" MajorTopicYN="N">Medication Adherence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D024802" MajorTopicYN="N">Nurse's Role</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010819" MajorTopicYN="N">Physician's Role</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">HIV/AIDS</Keyword><Keyword MajorTopicYN="N">Task-shifting</Keyword><Keyword MajorTopicYN="N">antiretroviral therapy</Keyword><Keyword MajorTopicYN="N">cost-effectiveness</Keyword><Keyword MajorTopicYN="N">effectiveness</Keyword><Keyword MajorTopicYN="N">human resources</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2012</Year><Month>6</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2012</Year><Month>6</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2014</Year><Month>1</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">22738755</ArticleId><ArticleId IdType="pii">czs058</ArticleId><ArticleId IdType="doi">10.1093/heapol/czs058</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li></country></list><tree><noCountry><name sortKey="Ali, Shehzad" sort="Ali, Shehzad" uniqKey="Ali S" first="Shehzad" last="Ali">Shehzad Ali</name><name sortKey="Chindove, Stanley" sort="Chindove, Stanley" uniqKey="Chindove S" first="Stanley" last="Chindove">Stanley Chindove</name></noCountry><country name="Royaume-Uni"><noRegion><name sortKey="Mdege, Noreen Dadirai" sort="Mdege, Noreen Dadirai" uniqKey="Mdege N" first="Noreen Dadirai" last="Mdege">Noreen Dadirai Mdege</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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