An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDS

Detalhes bibliográficos
Autor(a) principal: Ana Paula Loch
Data de Publicação: 2020
Outros Autores: Joselita Maria de Magalhães Caraciolo, Simone Queiroz Rocha, Mylva Fonsi, Rosa de Alencar Souza, Maria Clara Gianna, Alexandre Gonçalves, Artur Olhovetchi Kalichman
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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spelling 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
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dc.language.iso.fl_str_mv eng
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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
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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)
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instname_str Fundação Oswaldo Cruz (FIOCRUZ)
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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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