Featured Research

from universities, journals, and other organizations

Nurses Safely And Effectively Prescribe Antiretroviral Drugs In Pilot Program

Date:
October 12, 2009
Source:
Public Library of Science
Summary:
Given sufficient training and support, nurses can safely and effectively prescribe antiretroviral therapy to patients with HIV, according to a Rwandan study.

Given sufficient training and support, nurses can safely and effectively prescribe antiretroviral therapy (ART) to patients with HIV, according to a Rwandan study published in this week's PLoS Medicine.

Related Articles


As in many other African countries, Rwanda has a shortage of doctors, which implies that many patients with HIV aren't receiving the treatment they need. To tackle this crisis, the World Health Organization recommends "task shifting"—whereby the task of prescribing ART is shifted from doctors to nurses so that more patients can be treated.

In September 2005, Rwanda launched a pilot program of task shifting. One nurse in each of three rural primary health centers was trained to examine patients with HIV and prescribe ART in simple cases (complex cases were referred to a doctor). Nurses had to complete at least 50 consultations with patients eligible for ART under the observation of a doctor before being allowed to treat patients independently. The new study, by Fabienne Shumbusho (Family Health International, Kigali, Rwanda) and colleagues, evaluates the success and safety of the program.

Shumbusho and colleagues reviewed the medical records of 1,076 patients enrolled in the program between September 2005 and March 2008. They examined whether the nurses had followed national guidelines on ART prescription and monitored the patients correctly. They also looked at patients' health outcomes, such as their death rate, changes in body weight and CD4 cell count (a marker of how healthy the patient's immune system was), and whether patients maintained contact with caregivers.

The researchers found that by March 2008, 451 patients had been eligible for ART, of whom 435 received treatment. None of the patients were prescribed ART when they should not have been. Only one prescription did not follow national guidelines. At every visit, nurses were supposed to assess whether patients were taking their drugs (known as "adherence") and to monitor side effects. They did this most of the time (in 89% of clinic visits, nurses assessed adherence, and in 85% of visits they assessed side effects).

By March 2008, 390 (90%) patients were alive on ART, 29 (7%) had died, only one (under 1%) was lost to follow-up, and none had stopped treatment. Most patients gained weight in the first six months and their CD4 cell counts increased.

Outcomes, including death rate, were similar to those from the doctor-led Rwandan national ART program and other African national doctor-led programs.

The study, say the authors, "demonstrates the feasibility and suggests effectiveness of nurse-centered task shifting for decentralized ART services without compromising the quality of care." But there are also several limitations to the study, which the authors discuss in their paper. For example, the authors say that they did not directly compare outcomes from this nurse-centered model of care with those from traditional physician-centered models. This makes it difficult to ascertain if patients' outcomes were as a result of the nurses' role or due to doctors' intensive supervision.


Story Source:

The above story is based on materials provided by Public Library of Science. Note: Materials may be edited for content and length.


Journal Reference:

  1. Shumbusho F, van Griensven J, Lowrance D, Turate I, Weaver MA, et al. Task Shifting for Scale-up of HIV Care: Evaluation of Nurse-Centered Antiretroviral Treatment at Rural Health Centers in Rwanda. PLoS Medicine, 2009; 6 (10): e1000163 DOI: 10.1371/journal.pmed.1000163

Cite This Page:

Public Library of Science. "Nurses Safely And Effectively Prescribe Antiretroviral Drugs In Pilot Program." ScienceDaily. ScienceDaily, 12 October 2009. <www.sciencedaily.com/releases/2009/10/091012225546.htm>.
Public Library of Science. (2009, October 12). Nurses Safely And Effectively Prescribe Antiretroviral Drugs In Pilot Program. ScienceDaily. Retrieved December 18, 2014 from www.sciencedaily.com/releases/2009/10/091012225546.htm
Public Library of Science. "Nurses Safely And Effectively Prescribe Antiretroviral Drugs In Pilot Program." ScienceDaily. www.sciencedaily.com/releases/2009/10/091012225546.htm (accessed December 18, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, December 18, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Kids Die While Under Protective Services

Kids Die While Under Protective Services

AP (Dec. 18, 2014) As part of a six-month investigation of child maltreatment deaths, the AP found that hundreds of deaths from horrific abuse and neglect could have been prevented. AP's Haven Daley reports. (Dec. 18) Video provided by AP
Powered by NewsLook.com
UN: Up to One Million Facing Hunger in Ebola-Hit Countries

UN: Up to One Million Facing Hunger in Ebola-Hit Countries

AFP (Dec. 17, 2014) Border closures, quarantines and crop losses in West African nations battling the Ebola virus could lead to as many as one million people going hungry, UN food agencies said on Wednesday. Duration: 00:52 Video provided by AFP
Powered by NewsLook.com
When You Lose Weight, This Is Where The Fat Goes

When You Lose Weight, This Is Where The Fat Goes

Newsy (Dec. 17, 2014) Can fat disappear into thin air? New research finds that during weight loss, over 80 percent of a person's fat molecules escape through the lungs. Video provided by Newsy
Powered by NewsLook.com
Why Your Boss Should Let You Sleep In

Why Your Boss Should Let You Sleep In

Newsy (Dec. 17, 2014) According to research out of the University of Pennsylvania, waking up for work is the biggest factor that causes Americans to lose sleep. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins