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. 2024 Jan-Dec:23:23259582241274304.
doi: 10.1177/23259582241274304.

Clinical Outcomes of a Nurse-Delivered, Technology-Enabled HIV Outpatient Model

Sara Day  1 , Rebecca Wilkins  1 , Andrew Murungi  2 , Christina Antoniadi  1 , Yodit Fissahaye-Yimer  1 , Samuel Ohene-Adomako  1 , David Asboe  1 , Caroline Rae  1
Affiliations

Clinical Outcomes of a Nurse-Delivered, Technology-Enabled HIV Outpatient Model

Sara Day et al. J Int Assoc Provid AIDS Care. 2024 Jan-Dec.

Abstract

We evaluated Klick, a nurse-led, digitally enabled model of HIV outpatient care, launched in 2020. Klick's smartphone app offers online booking, remote nurse-led consultations, and results. An audit of Klick nurse-led consultations was conducted against BHIVA monitoring guidelines, and nurses were interviewed about their experience. Of 40 Klick patients audited, 4 of 5 BHIVA standards were met: 100% had documented co-medications, smoking history, blood pressure, and viral load data, and 89% received a cardiovascular risk calculation (Targets 97%-90%-90%-90%-90%). Compared to national BHIVA audit findings, Klick performed better across 22 of 24 comparable measures. Nurses safely managed a cohort comprising some complexity (eg, co-morbidities, polypharmacy); no cases were escalated off the pathway, and all were virologically suppressed. Using a digitally supported model, nurses effectively provided safe care to HIV-positive patients with predominantly stable health, enabling consultants to focus on more complex caseloads. Care was comprehensive and person-centered and obtained better outcomes compared to previous national audits.

Keywords: HIV; care model; mobile app; nurse-led; outpatients.

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Conflict of interest statement

Declaration of Conflicting InterestsSD, RW, YF-Y, SO-A, and CR have no conflicts of interest. AM is an employee of ViiV Healthcare and may own stock in GSK. CA received travel bursaries and conference registration fees from and participated in advisory boards for ViiV Healthcare and has appeared in peer support information videos for Gilead Sciences. DA participated in advisory boards for ViiV Healthcare.

Figures

Figure 1.
Figure 1.
Example of the medical proforma output following a nurse-led consultation.
Figure 2.
Figure 2.
Example of laboratory results view in the patient portal application.
Figure 3.
Figure 3.
Klick clinical audit results for (A) the 5 key BHIVA HIV monitoring targets and (B) all metrics assessed. BHIVA, British HIV Association; GP, general practitioner; STI, sexually transmitted infection; VL, viral load. aCVD risk was assessed in patients aged ≥40 years without preexisting CVD.
Figure 4.
Figure 4.
Results from the Klick audit compared with a national audit conducted in 2018. BMI, body mass index; GP, general practitioner; STI, sexually transmitted infection; VL, viral load. aCVD risk was assessed in patients aged ≥40 years without preexisting CVD.
See this image and copyright information in PMC

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