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Nurse versus doctor management of HIV-infected patients receiving antiretroviral therapy (CIPRA-SA): a randomised non-inferiority trial
Open accessAbstract
Background Expanded access to combination antiretroviral therapy (ART) in resource-poor settings is dependent on task shifting from doctors to other health-care providers. We compared outcomes of nurse versus doctor management of ART care for HIV-infected patients.Methods This randomised non-inferiority trial was undertaken at two South African primary-care clinics. HIV-positive individuals with a CD4 cell count of less than 350 cells per microL or WHO stage 3 or 4 disease were randomly assigned to nurse-monitored or doctor-monitored ART care. Patients were randomly assigned by stratified permuted block randomisation, and neither the patients nor those analysing the data were masked to assignment. The primary objective was a composite endpoint of treatment-limiting events, incorporating mortality, viral failure, treatment-limiting toxic effects, and adherence to visit schedule. Analysis was by intention to treat. Non-inferiority of the nurse versus doctor group for cumulative treatment failure was prespecified as an upper 95% CI for the hazard ratio that was less than 1.40. This study is registered with ClinicalTrials.gov, number NCT00255840.Findings 408 patients were assigned to doctor-monitored ART care and 404 to nurse-monitored ART care; all participants were analysed. 371 (46%) patients reached an endpoint of treatment failure: 192 (48%) in the nurse group and 179 (44%) in the doctor group. The hazard ratio for composite failure was 1.09 (95% CI 0.89-1.33), which was within the limits for non-inferiority. After a median follow-up of 120 weeks (IQR 60-144), deaths (ten vs 11), virological failures (44 vs 39), toxicity failures (68 vs 66), and programme losses (70 vs 63) were similar in nurse and doctor groups, respectively.Interpretation Nurse-monitored ART is non-inferior to doctor-monitored therapy. Findings from this study lend support to task shifting to appropriately trained nurses for monitoring of ART.Funding National Institutes of Health; United States Agency for International Development; National Institute of Allergy and Infectious Diseases.
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“In the field of HIV/AIDS, task shifting has been deemed imperative with evidence that nurses can prescribe antiretroviral treatments just as effectively as physicians”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [51]
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Cites
Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents
(1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-128-12_part_2-199806151-00003 · Cited by 5,197
Castro, K. G., Ward, J., Slutsker, L., Buehler, J. W., Jaffe, H. W., Berkelman, R. L., & Curran, J. W. (1993) · Clinical Infectious Diseases · doi:10.1093/clinids/17.4.802 · Cited by 4,347
The World Health report 2006 1 : Working together for health 2
Guilbert, J.-J. (2006) · Education for Health · doi:10.1080/13576280600937911 · Cited by 2,652
Granich, R., Gilks, C. F., Dye, C., Cock, K. M. D., & Williams, B. G. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61697-9 · Cited by 1,987
Egger, M., May, M., Chêne, G., Phillips, A. N., Ledergerber, B., Dabis, F., Costagliola, D. G., Monforte, A. D., de Wolf, F., Reiss, P., et al. (2002) · The Lancet · doi:10.1016/s0140-6736(02)09411-4 · Cited by 1,526
South African Health Review 2005.
Gray, A., Govender, M., Gengiah, T. N., & Singh, J. S. (2005) · South African Health Review · Cited by 1,313
Kennedy, C. O. (1971) · British Homeopathic journal · doi:10.1016/s0007-0785(71)80027-3 · Cited by 976
Substitution of doctors by nurses in primary care
Laurant, M. G. H., Reeves, D., Hermens, R., Braspenning, J., Grol, R. P. T. M., & Sibbald, B. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001271.pub2 · Cited by 961
The WHO public-health approach to antiretroviral treatment against HIV in resource-limited settings
Gilks, C. F., Crowley, S., Ekpini, R. E., Gove, S., Perriëns, J., Souteyrand, Y., Sutherland, D., Vitória, M., Guerma, T., & Cock, K. D. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69158-7 · Cited by 689
(1993) · Archives of Dermatology · doi:10.1001/archderm.1993.01680240023002 · Cited by 569
Fox, M. P., & Rosen, S. B. (2010) · Tropical Medicine & International Health · doi:10.1111/j.1365-3156.2010.02508.x · Cited by 552
Self-citationCurran, J. W., Debas, H. T., Arya, M., Kelley, P., Knobler, S., & Pray, L. A. (2005) · Cited by 534
Physicians' Experience with the Acquired Immunodeficiency Syndrome as a Factor in Patients' Survival
Kitahata, M. M., Koepsell, T. D., Deyo, R. A., Maxwell, C. L., Dodge, W. T., & Wagner, E. H. (1996) · New England Journal of Medicine · doi:10.1056/nejm199603143341106 · Cited by 456
Bedelu, M., Ford, N. P., Hilderbrand, K., & Reuter, H. (2007) · The Journal of Infectious Diseases · doi:10.1086/521114 · Cited by 263
Fairall, L. R., Zwarenstein, M., Bateman, E. D., Bachmann, M. O., Lombard, C. J., Majara, B. P., Joubert, G., English, R., Bheekie, A., van Rensburg, D. H., et al. (2005) · BMJ · doi:10.1136/bmj.331.7519.750 · Cited by 172
Shumbusho, F., van Griensven, J., Lowrance, D. W., Turate, I., Weaver, M. A., Price, J., & Binagwaho, A. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000163 · Cited by 155
WORK-SITE TREATMENT OF HYPERTENSION BY SPECIALLY TRAINED NURSES
Logan, A., Achber, C., Milne, B. J., Campbell, W., & Haynes, R. B. (1979) · The Lancet · doi:10.1016/s0140-6736(79)92397-3 · Cited by 148
Boulle, A., Orrell, C., Kaplan, R., Cutsem, G. V., McNally, M., Hilderbrand, K., Myer, L., Egger, M., Coetzee, D. J., Maartens, G., et al. (2007) · Antiviral Therapy · doi:10.1177/135965350701200508 · Cited by 139
Self-citationPhysician Specialization and the Quality of Care for Human Immunodeficiency Virus Infection
Landon, B. E. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.10.1133 · Cited by 130
Cohen, R., Lynch, S., Bygrave, H., Eggers, E., Vlahakis, N., Hilderbrand, K., Knight, L., Pillay, P., Saranchuk, P., Goemaere, E., et al. (2009) · Journal of the International AIDS Society · doi:10.1186/1758-2652-12-23 · Cited by 128
Kitahata, M. M., Rompaey, S. E. V., & Shields, A. W. (2000) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-200006010-00004 · Cited by 87
The relationship of clinic experience with advanced HIV and survival of women with AIDS
Laine, C. M., Markson, L. E., McKee, L. J., Hauck, W. W., Fanning, T. R., & Turner, B. J. (1998) · AIDS · doi:10.1097/00002030-199804000-00011 · Cited by 82
van Griensven, J., Naeyer, L. D., Uwera, J., Asiimwe, A., Gazille, C., & Reid, T. (2008) · BMC Pediatrics · doi:10.1186/1471-2431-8-39 · Cited by 73
Miles, K. (2007) · Bulletin of the World Health Organization · doi:10.2471/blt.06.033076 · Cited by 68
Human resources requirements for highly active antiretroviral therapy scale-up in Malawi
Muula, A. S., Chipeta, J., Siziya, S., Rudatsikira, E., Mataya, R. H., & Kataika, E. (2007) · BMC Health Services Research · doi:10.1186/1472-6963-7-208 · Cited by 47
Establishing a workplace antiretroviral therapy programme in South Africa
Charalambous, S., Grant, A. D., Day, J. H., Pemba, L., Chaisson, R. E., Kruger, P., Martin, D. J., Wood, R., Brink, B., & Churchyard, G. (2006) · AIDS Care · doi:10.1080/09500340600677872 · Cited by 47
Self-citationStrengthening human resources for primary health care
Lehmann, U. (2008) · UWC Research Repository (University of the Western Cape) · Cited by 40
Smith, S., Robinson, J., Hollyer, J., Bhatt, R., Ash, S., & Shaunak, S. (1996) · BMJ · doi:10.1136/bmj.312.7028.416 · Cited by 29
Assefa, Y. A., & Kloos, H. (2008) · PubMed · Cited by 22
Primary care for patients infected with human immunodeficiency virus
Keitz, S. A., Box, T. L., Homan, R. K., Bartlett, J. A., & Oddone, E. Ž. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009573.x · Cited by 21
HIV infection: the role of primary care.
Romanelli, F., & Matheny, S. C. (2009) · PubMed · Cited by 16
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Thompson, M., Mugavero, M. J., Amico, K. R., Cargill, V. A., Chang, L. W., Gross, R., Orrell, C., Altice, F. L., Bangsberg, D. R., Bartlett, J. G., et al. (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-156-11-201206050-00419 · Cited by 585
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Fulton, B. D., Scheffler, R. M., Sparkes, S. P., Auh, E. Y., Vujicic, M., & Soucat, A. L. B. (2011) · Human Resources for Health · doi:10.1186/1478-4491-9-1 · Cited by 566
Govindasamy, D., Ford, N., & Kranzer, K. (2012) · AIDS · doi:10.1097/qad.0b013e3283578b9b · Cited by 435
Global Burden of Skin Disease: Inequities and Innovations
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Metadata
- Authors
- Sanne, I., Orrell, C., Fox, M. P., Conradie, F., Ive, P., Zeinecker, J., Cornell, M., Heiberg, C., Ingram, C., Panchia, R., Rassool, M., Gonin, R., Stevens, W., Truter, H., Dehlinger, M., van der Horst, C., McIntyre, J., & Wood, R.
- Affiliations
- University of the Witwatersrand (ZA)
- University of Cape Town (ZA)
- Boston University (US)
- Westat (United States) (US)
- National Institute of Allergy and Infectious Diseases (US)
- Corresponding author
- Orrell, Catherine
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 376
- Issue
- 9734
- Pages
- 33-40
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC3145152
- OpenAlex
- W2169980588
- Cited by
- 248
- References
- 34
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 7 · 2023: 3 · 2022: 2 · 2021: 7 · 2020: 12 · 2019: 9 · 2018: 10 · 2017: 17 · 2016: 14 · 2015: 13 · 2014: 32 · 2013: 35 · 2012: 45
- FWCI
- 24.59
- Type
- journal article
- Language
- en
- Update notices
- erratum (2010-09-25)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- United States Agency for International Development
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- National Institute of Allergy and Infectious Diseases (1U19 AI53217-01, P30 AI50410, U19AI053217, K01AI083097, P30AI050410)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Keywords
- HIV infection, antiretroviral therapy, nurse-led care, task shifting, non-physician health workers, primary care, treatment failure, virological failure, drug toxicity, patient adherence, resource-limited settings, South Africa
- MeSH terms
- Adult, Drug Therapy, Combination, Female, Humans, Male, Physicians, South Africa, HIV-1, HIV Infections, Drug Monitoring, Treatment Failure, Anti-Retroviral Agents
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