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Healthcare provider perspectives on barriers and facilitators to integration of cardiovascular disease-related care into HIV care and treatment clinics in urban Tanzania.

作者信息

Ottaru Theresia A, Ngakongwa Fileuka C, Butt Zeeshan, Hawkins Claudia A, Kaaya Sylvia F, Metta Emmy O, Chillo Pilly, Siril Helen N, Hirschhorn Lisa R, Kwesigabo Gideon P

机构信息

Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

出版信息

Front Public Health. 2024 Dec 24;12:1483476. doi: 10.3389/fpubh.2024.1483476. eCollection 2024.


DOI:10.3389/fpubh.2024.1483476
PMID:39776488
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11703862/
Abstract

BACKGROUND: The increase in the dual burden of HIV and cardiovascular diseases (CVD), calls for the provision of integrated HIV/CVD care. This study aimed to explore barriers and facilitators to the integration of HIV/CVD care within HIV care and treatment clinics (CTCs) in urban, Tanzania. METHODS: Between March and April 2023, we conducted 12 key informant interviews with healthcare providers at six HIV CTCs in urban, Tanzania. Guided by the Consolidated Framework for Implementation Research (CFIR 1.0), we designed the interview guide and conducted a thematic analysis. RESULTS: Out of the 11 CFIR constructs explored, three were barriers (cost, availability of resources, and access to information and knowledge), six were facilitators (complexity, relative advantage, patient needs, external policies and incentives, relative priority, and knowledge and belief about the intervention), and two (compatibility and self-efficacy) were both barriers and facilitators. Barriers to integration included a lack of equipment, such as BP machines, lack of space, unavailability of an electronic data-capturing tool at the HIV CTCs for monitoring CVD outcomes, and a shortage of trained healthcare workers, particularly in managing CVD comorbidities according to current recommendations. Providers acknowledged the increasing demand for CVD care among ALHIV and regarded integration as not a complex task. Providers reported that both services could be delivered simultaneously without disrupting client workflow and were determined to offer integrated care within HIV CTCs. Providers expressed concerns about medication costs and recommended that medications should be provided for free as part of the integrated care. CONCLUSION: Effective and sustainable HIV/CVD integrated care requires an understating of the existing barriers and facilitators within the HIV CTCs. This study identifies key barriers at HIV CTCs that must be addressed and facilitators to be leveraged before CVD care is integrated into HIV CTCs to ensure that CVD care is delivered effectively within an integrated system.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c37/11703862/1b09a72bfeec/fpubh-12-1483476-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c37/11703862/1b09a72bfeec/fpubh-12-1483476-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c37/11703862/1b09a72bfeec/fpubh-12-1483476-g001.jpg

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[1]
Healthcare provider perspectives on barriers and facilitators to integration of cardiovascular disease-related care into HIV care and treatment clinics in urban Tanzania.

Front Public Health. 2024-12-24

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本文引用的文献

[1]
Understanding barriers and facilitators to integrated HIV and hypertension care in South Africa.

Implement Sci Commun. 2024-8-1

[2]
Long-term impact of an integrated HIV/non-communicable disease care intervention on patient retention in care and clinical outcomes in East Africa.

Trop Med Int Health. 2024-8

[3]
Dissemination and implementation research coordination and training to improve cardiovascular health in people living with HIV in sub-Saharan Africa: the research coordinating center of the HLB-SIMPLe Alliance.

Implement Sci Commun. 2024-6-6

[4]
Integrated chronic care models for people with comorbid of HIV and non-communicable diseases in Sub-Saharan Africa: A scoping review.

PLoS One. 2024

[5]
"I only seek treatment when I am ill": experiences of hypertension and diabetes care among adults living with HIV in urban Tanzania.

BMC Health Serv Res. 2024-2-9

[6]
Ideal Cardiovascular Health: Distribution, Determinants and Relationship with Health Status among People Living with HIV in Urban Tanzania.

Glob Heart. 2022

[7]
The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health.

J Am Coll Cardiol. 2022-12-20

[8]
Integrating hypertension and HIV care in Namibia: A quality improvement collaborative approach.

PLoS One. 2022

[9]
The acceptability of integrated healthcare services for HIV and non-communicable diseases: experiences from patients and healthcare workers in Tanzania.

BMC Health Serv Res. 2022-5-16

[10]
Integrating Care for Diabetes and Hypertension with HIV Care in Sub-Saharan Africa: A Scoping Review.

Int J Integr Care. 2022-1-31

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