Integrating Long-Acting Antiretrovirals into Clinic Care

Core Concepts

Clinics are successfully integrating long-acting antiretrovirals into their care programs, improving patient outcomes and satisfaction.

Abstract

New long-acting cabotegravir formulation available for HIV treatment. Whitman-Walker Health Center integrates long-acting injections into peer staff program. Training program for peer workers includes various components. High retention rates and client satisfaction reported. Challenges and benefits of long-acting injectables discussed. San Francisco General Hospital Clinic offers injections to patients with viremia. Positive outcomes and low virological failure rates observed. Motivation and satisfaction among patients receiving injections highlighted.

Stats

"139 people have received long-acting injections at the clinic since the program launched with a total of 314 injections administered." "Retention for the second injection was 95%, with 91% of injections given within the 14-day window." "For the third injection, retention was 91%, with 63% given within the window." "The overall virological failure rate was 1.5%, which was equivalent to that seen in clinical trials in virologically suppressed individuals." "73% of people attended their injection appointments on time."

Quotes

"Our retention is going to be the highest compared to other clinics because your peer, your friend, is reminding you and comforting you and telling you, 'Don't worry, I'm on the injection too.'" - Rupa Patel "We don't call people hard to reach, we call them hardly reached because it's not their fault." - Monica Gandhi "They are virologically suppressed, so it feels so amazing. They're self-motivated for the first time to want to get an injection." - Monica Gandhi

Key Insights Distilled From

Injecting Long-Acting Antiretrovirals Into Clinic Care

by Bianca Nogra... at www.medscape.com 08-01-2023

https://www.medscape.com/viewarticle/995030

Deeper Inquiries

How can clinics ensure long-term success with integrating long-acting antiretrovirals?

Clinics can ensure long-term success with integrating long-acting antiretrovirals by implementing comprehensive training programs for staff, including peer workers, to ensure they are proficient in administering injections and providing follow-up care. Regular monitoring and evaluation of patient outcomes, such as retention rates and virological suppression, can help clinics identify areas for improvement and adjust their protocols accordingly. Additionally, creating a supportive and welcoming environment for patients receiving injections, as seen in the example of using a beach-themed room with calming music, can help reduce anxiety and improve patient satisfaction, leading to better adherence to treatment.

What are the potential drawbacks or risks associated with relying on peer-administered injections?

Relying on peer-administered injections may pose certain risks or drawbacks. One potential concern is the level of training and supervision provided to peer workers to ensure they are competent in administering injections safely and effectively. There may also be challenges in maintaining consistency and quality of care across different peer workers, which could impact patient outcomes. Additionally, there is a risk of potential breaches in confidentiality or privacy if peer workers are not adequately trained in handling sensitive medical information. It is essential for clinics to have robust protocols in place to address these risks and ensure the highest standards of care when utilizing peer-administered injections.

How can the healthcare system better support individuals who face challenges in adhering to daily medication regimens?

The healthcare system can better support individuals who face challenges in adhering to daily medication regimens by implementing personalized care plans that take into account the unique needs and circumstances of each patient. This may involve providing additional resources and support, such as mental health services, substance abuse treatment, or housing assistance, to address the underlying factors contributing to medication non-adherence. Utilizing technologies like medication reminders, telehealth services, and mobile health apps can also help individuals stay on track with their treatment regimens. Furthermore, fostering a non-judgmental and empathetic healthcare environment where patients feel heard and supported can encourage open communication and collaboration in managing medication adherence challenges.