METHODS Team, Centre de Recherche Epidemiologie et Statistiques Sorbonne Paris Cité (CRESS UMR 1153), Paris, France.
Centre d'Epidémiologie Clinique-Hôpital Hôtel-Dieu, Assistance Publique-Hopitaux de Paris, Paris, France.
BMJ Qual Saf. 2019 Apr;28(4):266-275. doi: 10.1136/bmjqs-2017-007564. Epub 2018 Apr 29.
Patients living with HIV infection (PLWH) in sub-Saharan Africa face an important burden of treatment related to everything they do to take care of their health: doctor visits, tests, regular refills, travels, and so on. In this study, we involved PLWH in proposing ideas on how to decrease their burden of treatment and assessed to what extent these propositions could be implemented in care.
Adult PLWH recruited in three HIV care centres in Côte d'Ivoire participated in qualitative interviews starting with '' Two independent investigators conducted a thematic analysis to identify and classify patients' propositions to decrease their burden of treatment. A group of experts involving patients, health professionals, hospital leaders and policymakers evaluated each patient proposition to assess its feasibility.
Between February and April 2017, 326 participants shared 748 ideas to decrease their burden of treatment. These ideas were grouped into 59 unique patient propositions to improve their personal care and the organisation of their hospital or clinic and/or the health system. Experts considered that 27 (46%), 19 (32%) and 13 (22%) of patients' propositions were easy, moderate and difficult, respectively, to implement. A total of 118 (36%) participants offered at least one proposition considered easily implementable by our experts.
Asking PLWH in sub-Saharan Africa about how their care could be improved led to identifying meaningful propositions. According to experts, half of the ideas identified could be implemented easily at low cost for minimally disruptive HIV care.
撒哈拉以南非洲的艾滋病毒感染者（PLWH）面临着与他们为保持健康所做的一切相关的重要治疗负担：就诊、检查、定期续药、旅行等等。在这项研究中，我们让 PLWH 参与提出减少治疗负担的想法，并评估这些建议在护理中能够实施到什么程度。
在科特迪瓦的三个艾滋病毒护理中心招募成年 PLWH 参加定性访谈，从“负担”开始。两名独立调查员进行了主题分析，以确定和分类患者减少治疗负担的建议。一组由患者、卫生专业人员、医院领导和政策制定者组成的专家对每个患者的建议进行评估，以评估其可行性。
2017 年 2 月至 4 月期间，326 名参与者共提出了 748 条减少治疗负担的建议。这些想法分为 59 条独特的患者建议，以改善他们的个人护理以及他们的医院或诊所和/或卫生系统的组织。专家认为，27 项（46%）、19 项（32%）和 13 项（22%）患者建议分别容易、中等和难以实施。共有 118 名（36%）参与者提出了至少一项被我们专家认为易于实施的建议。
询问撒哈拉以南非洲的 PLWH 如何改善他们的护理，有助于确定有意义的建议。根据专家的说法，确定的想法中有一半可以以低成本轻松实施，对艾滋病毒护理的干扰最小。
