An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDS
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng por |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473 |
Resumo: | The clinical monitoring of people living with HIV/AIDS (PLWHA) contributes to identifying and managing cases of individuals who have not begun treatment (gap), those experiencing treatment failure or who have abandoned treatment. This article sought to present and discuss the development of a methodology to implement the clinical monitoring of PLWHA in the services of the Brazilian Unified National Health System (SUS). The methodology used since 2014 by the CRT-STI/AIDS-Coordination of the STI/AIDS Program, São Paulo State, Brazil, was re-structured in three meetings between June and August 2018. The new methodology retained the axes of presentation of number of users in treatment failure, gap or abandonment in the participant services, as well as the discussion of individual, social and programmatic vulnerabilities. A new axis was added which directs the discussion of the possibilities of reorganizing service care flows and management practices. Additionally, the intervention started to be carried out in health services, with the participation of a higher number of professionals from the multi-professional team, discussion of cases, workflows and processes, and regional meetings to exchange clinical monitoring experiences between services. The re-structuring of the methodology contributed to a reduction in treatment gap, a reorganization of care flows and the inclusion of clinical monitoring as a management tool in services specialized in providing care to PLWHA. This methodology can be implemented by other state programs, municipalities and services, since all have access to the same information sources used in this intervention. |
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An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDSIntervenção para a implementação do monitoramento clínico em serviços especializados de atenção às pessoas vivendo com HIV/aidsProcess Assessment (Health Care)Treatment AdherenceUnified Health SystemHIVImplementation ScienceAvaliação de Processos (Cuidados de Saúde)Adesão ao TratamentoSistema Único de SaúdeHIVCiência da ImplementaçãoThe clinical monitoring of people living with HIV/AIDS (PLWHA) contributes to identifying and managing cases of individuals who have not begun treatment (gap), those experiencing treatment failure or who have abandoned treatment. This article sought to present and discuss the development of a methodology to implement the clinical monitoring of PLWHA in the services of the Brazilian Unified National Health System (SUS). The methodology used since 2014 by the CRT-STI/AIDS-Coordination of the STI/AIDS Program, São Paulo State, Brazil, was re-structured in three meetings between June and August 2018. The new methodology retained the axes of presentation of number of users in treatment failure, gap or abandonment in the participant services, as well as the discussion of individual, social and programmatic vulnerabilities. A new axis was added which directs the discussion of the possibilities of reorganizing service care flows and management practices. Additionally, the intervention started to be carried out in health services, with the participation of a higher number of professionals from the multi-professional team, discussion of cases, workflows and processes, and regional meetings to exchange clinical monitoring experiences between services. The re-structuring of the methodology contributed to a reduction in treatment gap, a reorganization of care flows and the inclusion of clinical monitoring as a management tool in services specialized in providing care to PLWHA. This methodology can be implemented by other state programs, municipalities and services, since all have access to the same information sources used in this intervention.El monitoreo clínico de personas afectadas por el VIH/SIDA (PVHA) contribuye a la identificación y gestión de caso de personas sin inicio de tratamiento (gap), con fallos en la parte terapéutica y abandono del tratamiento. El objetivo de este artículo es presentar y discutir el desarrollo de una metodología para la implementación del monitoreo clínico de las PVHA en servicios del Sistema Único de Salud (SUS). La metodología utilizada desde 2014 por el CRT-ETS/SIDA-Coordinación del Programa Estatal de ETS/SIDA del Estado de São Paulo, Brasil, fue reestructurada en tres reuniones, durante el período de junio a agosto de 2018. Se mantuvieron los ejes de presentación del número de usuarios con fallos en la parte terapéutica, gap y con abandono de tratamiento en los servicios participantes estudiados, así como la discusión de vulnerabilidades individuales, sociales y programáticas. Se añadió un nuevo eje que vertebra la discusión sobre las posibilidades de reorganización de los flujos asistenciales y prácticas de gestión del servicio. Asimismo, la intervención pasó a realizarse en los servicios de salud, con la participación de un mayor número de profesionales del equipo multiprofesional, discusión de casos, flujos y procesos de trabajo, así como encuentros regionales para el intercambio de experiencias en el monitoreo clínico entre los servicios. La reestructuración de la metodología contribuyó a la disminución del gap en el tratamiento, la reorganización de flujos asistenciales, así como la inclusión del monitoreo clínico como herramienta de gestión en los servicios de asistencia especializada a las PVHA. Esta metodología puede ser implementada en otros programas estatales, municipios y servicios, ya que todos tienen acceso a las mismas fuentes de información usadas en esta intervención.O monitoramento clínico de pessoas vivendo com HIV/aids (PVHA) contribui para a identificação e gestão de caso das pessoas sem início de tratamento (gap), em falha terapêutica e em abandono de tratamento. O objetivo deste artigo é apresentar e discutir o desenvolvimento de uma metodologia para a implementação do monitoramento clínico das PVHA em serviços do Sistema Único de Saúde (SUS). A metodologia utilizada desde 2014 pelo Centro de Referência e Treinamento DST/AIDS-SP-Coordenação do Programa Estadual de IST/AIDS do Estado de São Paulo, Brasil, foi reestruturada em três reuniões, no período de junho a agosto de 2018. Foram mantidos os eixos de apresentação do número de usuários com falha terapêutica, em gap e em abandono de tratamento nos serviços participantes, e a discussão de vulnerabilidades individuais, sociais e programáticas. Foi adicionado um novo eixo que direciona a discussão das possibilidades de reorganização de fluxos assistenciais e práticas gerenciais do serviço. Adicionalmente, a intervenção passou a ser feita nos serviços de saúde, com a participação de um número maior de profissionais da equipe multiprofissional, discussão de casos, fluxos e processos de trabalho e encontros regionais para a troca de experiências em monitoramento clínico entre os serviços. A reestruturação da metodologia contribuiu para a diminuição do gap de tratamento, reorganização de fluxos assistenciais e inclusão do monitoramento clínico como ferramenta de gestão nos serviços de assistência especializada às PVHA. Essa metodologia pode ser implementada por outros programas estaduais, municípios e serviços, uma vez que todos têm acesso às mesmas fontes de informação usadas nesta intervenção.Reports in Public HealthCadernos de Saúde Pública2020-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmltext/htmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473Reports in Public Health; Vol. 36 No. 5 (2020): MayCadernos de Saúde Pública; v. 36 n. 5 (2020): Maio1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZengporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473/16548https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473/16549https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473/16550https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473/16551Ana Paula LochJoselita Maria de Magalhães CaracioloSimone Queiroz RochaMylva FonsiRosa de Alencar SouzaMaria Clara GiannaAlexandre GonçalvesArtur Olhovetchi Kalichmaninfo:eu-repo/semantics/openAccess2024-03-06T15:29:57Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/7473Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:08:35.452956Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDS Intervenção para a implementação do monitoramento clínico em serviços especializados de atenção às pessoas vivendo com HIV/aids |
title |
An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDS |
spellingShingle |
An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDS Ana Paula Loch Process Assessment (Health Care) Treatment Adherence Unified Health System HIV Implementation Science Avaliação de Processos (Cuidados de Saúde) Adesão ao Tratamento Sistema Único de Saúde HIV Ciência da Implementação |
title_short |
An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDS |
title_full |
An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDS |
title_fullStr |
An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDS |
title_full_unstemmed |
An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDS |
title_sort |
An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDS |
author |
Ana Paula Loch |
author_facet |
Ana Paula Loch Joselita Maria de Magalhães Caraciolo Simone Queiroz Rocha Mylva Fonsi Rosa de Alencar Souza Maria Clara Gianna Alexandre Gonçalves Artur Olhovetchi Kalichman |
author_role |
author |
author2 |
Joselita Maria de Magalhães Caraciolo Simone Queiroz Rocha Mylva Fonsi Rosa de Alencar Souza Maria Clara Gianna Alexandre Gonçalves Artur Olhovetchi Kalichman |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Ana Paula Loch Joselita Maria de Magalhães Caraciolo Simone Queiroz Rocha Mylva Fonsi Rosa de Alencar Souza Maria Clara Gianna Alexandre Gonçalves Artur Olhovetchi Kalichman |
dc.subject.por.fl_str_mv |
Process Assessment (Health Care) Treatment Adherence Unified Health System HIV Implementation Science Avaliação de Processos (Cuidados de Saúde) Adesão ao Tratamento Sistema Único de Saúde HIV Ciência da Implementação |
topic |
Process Assessment (Health Care) Treatment Adherence Unified Health System HIV Implementation Science Avaliação de Processos (Cuidados de Saúde) Adesão ao Tratamento Sistema Único de Saúde HIV Ciência da Implementação |
description |
The clinical monitoring of people living with HIV/AIDS (PLWHA) contributes to identifying and managing cases of individuals who have not begun treatment (gap), those experiencing treatment failure or who have abandoned treatment. This article sought to present and discuss the development of a methodology to implement the clinical monitoring of PLWHA in the services of the Brazilian Unified National Health System (SUS). The methodology used since 2014 by the CRT-STI/AIDS-Coordination of the STI/AIDS Program, São Paulo State, Brazil, was re-structured in three meetings between June and August 2018. The new methodology retained the axes of presentation of number of users in treatment failure, gap or abandonment in the participant services, as well as the discussion of individual, social and programmatic vulnerabilities. A new axis was added which directs the discussion of the possibilities of reorganizing service care flows and management practices. Additionally, the intervention started to be carried out in health services, with the participation of a higher number of professionals from the multi-professional team, discussion of cases, workflows and processes, and regional meetings to exchange clinical monitoring experiences between services. The re-structuring of the methodology contributed to a reduction in treatment gap, a reorganization of care flows and the inclusion of clinical monitoring as a management tool in services specialized in providing care to PLWHA. This methodology can be implemented by other state programs, municipalities and services, since all have access to the same information sources used in this intervention. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473 |
dc.language.iso.fl_str_mv |
eng por |
language |
eng por |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473/16548 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473/16549 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473/16550 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7473/16551 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html text/html application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 36 No. 5 (2020): May Cadernos de Saúde Pública; v. 36 n. 5 (2020): Maio 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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1798943392433963008 |