长效注射型抗逆转录病毒药物治疗 HIV:ICONA 队列研究中医生和护士的观点。
Long-acting injectable antiretrovirals for HIV treatment in the ICONA cohort: physicians' and nurses' points of view.
机构信息
Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
Università Cattolica S. Cuore, Roma, Italy.
出版信息
J Antimicrob Chemother. 2024 Oct 1;79(10):2662-2667. doi: 10.1093/jac/dkae273.
BACKGROUND
Implementation level of long-acting injectable agents cabotegravir/rilpivirine (LAI CAB/RPV) for human immunodeficiency virus (HIV) treatment in Italy is still not known. The aim of this study is to identify the status of implementation of LAI CAB-RPV and its barriers.
MATERIALS AND METHODS
A cross-sectional online survey was conducted among infectious diseases (ID) physicians and nurses belonging to the ICONA network in Italy. Three validate 4-items measures were used: Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM) and Feasibility of Intervention Measure (FIM).
RESULTS
Out of 61 ICONA centres, 38 (62%) completed the survey: 57.9% were academic centres, 42.1% were hospital-based. In total, 104 respondents were ID physicians (57.4%), 77 were nurses (42.5%); 4.5% of all PWH followed at the 38 centres started LAI CAB/RPV at time of study. Centres taking care of >1000 PWH reported 95% application of procedures for LA implementation, higher than other centres (P = 0.009). Mean score of AIM was (16.0, standard deviation, SD, 3.3), of IAM (16.0, SD 3.0) and FIM (16.0, SD 2.9). A linear correlation was found between AIM and the number of people with HIV who started LAI CAB/RPV (25-50 versus <25, coefficient of correlation [b] 2.57, 95%CI 0.91-4.60, P = 0.004), academic versus hospital-based centres (b -1.59, 95%CI -2.76-0.110044, P = 0.007) and the absence of preliminary systematic assessment of staff (b -1.98, 95%CI -3.31-0.65, P = 0.004). Implementation barriers were not significantly different according to the number of PWH/centre.
CONCLUSIONS
LAI CAB/RPV implementation was low, with a great variability according to centre size. Tailored and centre-specific interventions to address barriers and to optimize the LA treatment implementation should be designed.
背景
在意大利,长效注射型 cabotegravir/rilpivirine(LAI CAB/RPV)用于艾滋病毒(HIV)治疗的实施情况尚不清楚。本研究旨在确定 LAI CAB-RPV 的实施状况及其障碍。
材料和方法
在意大利 ICONA 网络中的传染病(ID)医生和护士中进行了一项横断面在线调查。使用了三个经过验证的 4 项措施:干预措施可接受性测量(AIM)、干预措施适宜性测量(IAM)和干预措施可行性测量(FIM)。
结果
在 61 个 ICONA 中心中,有 38 个(62%)完成了调查:57.9%为学术中心,42.1%为医院为基础的中心。共有 104 名 ID 医生(57.4%)和 77 名护士(42.5%)参与了调查;在 38 个中心接受治疗的所有 HIV 感染者中,有 4.5%在研究时开始使用 LAI CAB/RPV。报告照顾超过 1000 名 HIV 感染者的中心实施 LA 程序的比例为 95%,高于其他中心(P=0.009)。AIM 的平均得分为(16.0,标准差,SD,3.3),IAM 为(16.0,SD 3.0),FIM 为(16.0,SD 2.9)。发现 AIM 与开始使用 LAI CAB/RPV 的 HIV 感染者人数之间存在线性相关性(25-50 人与 <25 人相比,相关性系数 [b]2.57,95%CI0.91-4.60,P=0.004),学术中心与医院为基础的中心(b-1.59,95%CI-2.76-0.110044,P=0.007)和缺乏对员工的初步系统评估(b-1.98,95%CI-3.31-0.65,P=0.004)。根据中心人数,实施障碍无显著差异。
结论
LAI CAB/RPV 的实施情况较低,根据中心规模存在较大差异。应设计有针对性和特定于中心的干预措施,以解决障碍并优化 LA 治疗的实施。