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. 2009 Nov-Dec;100(6):459-62.
doi: 10.1007/BF03404344.

[Treatment of HIV marginalized patients: an approach to documenting medical and psychosocial appointments of patients with problematic drug use]

[Article in French]
Michel Perreault  1 , Manon Mousseau, Catherine Laurier, Daniel Rabouin, Sylvie Desbiens, Pierre Côté, Danielle Rouleau, Claire Lahaie, Marc-André Charron, Marie-Josée Carbonneau
Affiliations

[Treatment of HIV marginalized patients: an approach to documenting medical and psychosocial appointments of patients with problematic drug use]

[Article in French]
Michel Perreault et al. Can J Public Health. 2009 Nov-Dec.

Abstract
in English, French

Objective: To document compliance with medical and psychosocial appointments for HIV/AIDS treatment in a population of marginalized individuals with problematic drug use.

Method: This is a retrospective study exploring appointment compliance for an HIV treatment based on an outreach intervention. Information regarding the medical and psychosocial appointments of 185 patients of the HIV-Drug Addiction outpatient unit, at the University of Montreal Hospital Centre (CHUM), has been collected for a one-year period (2006-2007). The compliance rate of appointments has been calculated according to the type of care provided: 1) conventional, provided only in the clinic at the "fixed" location, and 2) outreach-based, when the team at the fixed location is complemented by the intervention of a "mobile" team for the more unstable patients.

Results: Compliance rates for medical and psychosocial appointments in patients receiving care solely at the fixed location is 61.4%. For those whom care is received at the fixed location while complemented by the mobile team, the corresponding rate is 73.9%. This is an elevated compliance rate, higher than those generally reported for outreach-based programs.

Conclusion: These results lend support to the success of programs integrating an outreach-based intervention for a vulnerable clientele. Indeed, appointment compliance in those who are more disorganized, for which the mobile team has intervened, has proven comparable and even superior to compliance with appointments when treatment is only received at the fixed location.

Objectifs: Documenter l’observance des rendez-vous médicaux et psychosociaux chez une population de personnes marginalisées et toxicomanes en traitement pour le VIH/sida.

Méthode: Étude rétrospective sur le respect des rendez-vous à un traitement du VIH caractérisé par une approche de proximité. Les informations sur les rendez-vous médicaux et psychosociaux de 185 patients suivis à l’unité ambulatoire VIH-Toxicomanie du Centre Hospitalier de l’Université de Montréal (CHUM) ont été colligées pour une période d’un an (2006–2007). Les taux d’observance des rendez-vous ont été établis selon le type de suivi prodigué: 1) conventionnel, dispensé uniquement à la clinique du site ªfixe« et 2) de proximité, quand l’équipe du site fixe est appuyée par l’intervention d’une équipe ªmobile« auprès des patients plus instables.

Résultats: Le taux d’observance des rendez-vous médicaux et psychosociaux chez les patients suivis uniquement au site fixe est de 61,4%. Pour ceux dont le suivi au site fixe est combiné à l’intervention de l’équipe mobile, le taux correspondant est de 73,9%. Il s’agit d’un taux élevé, supérieur à ceux généralement observés pour des programmes de proximité.

Conclusion: Ces résultats tendent à soutenir le succès des approches de proximité pour rejoindre les clientèles vulnérables. En effet, l’observance des rendez-vous chez les personnes plus désorganisées, pour lesquelles l’équipe mobile est intervenue, s’est avérée comparable et même supérieure à celles suivies uniquement au site fixe.

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