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Dr Edna Maselle holds a Bachelors of Medicine and Bachelors of Surgery (MBchB) from Mbarara University of Science and Technology in Mbarara, Uganda. For the past four years she has been working as a Medical Officer at the Mulago HIV/AIDS clinic under the Makerere University Joint AIDS Program (MJAP), a PEPFAR funded HIV/AIDS program.
During the four years of providing HIV care she has been challenged by ever increasing patient numbers and developed interest in innovations which can support access to quality HIV care. Her interest has been on evaluating the uptake of pharmacy only visits (POV) for clinically stable HIV-infected patients.
Dr Maselle has written two abstracts on the subject of POV as a result she was awarded the best upcoming young researcher award at the 8th Joint Annual Scientific Conference organized by Makerere University College of Health Science (MakCHS) and World Health Organization (WHO) in 2012. Dr Maselle recently enrolled for a master of Public Health program where she is working towards her ambition of becoming a public health specialist with grounding in HIV service improvement.
Dr Maselle can be contacted through:
Reducing Turnaround Time (TAT) Does Not Improve Retention Of Stable HIV-infected Adults On Pharmacy Only Visits (POV)
Program: Experience From An HIV Clinic In Uganda.
Abstract text (max 2500 characters incl spaces):
Background: HIV/ AIDS clinics in resource limited settings (RLS) face increasing number of patients and workforce shortage. To address these challenges, efficient models of care such as pharmacy only visits (POV) and nurse only visits (NOV) are recommended. The Makerere University Joint AIDS Program (MJAP), a PEPFAR funded program providing care to over 42,000 HIV infected adults has implemented the POV model since 2009. In this model, stable patients on antiretroviral therapy (ART) with adherence to ART > 95% and Karnofsky score >90% are reviewed by a doctor every four months but visit pharmacy for ART refills every two months. A study conducted in August 2011 showed low retention on the POV program with symptomatic diseases, pending CD4 count, complete blood count results, and poor adherence to ART as the major reasons for the non-retention in the POV program. To improve retention on POV, the TAT (Turnaround Time) for laboratory results (the main reason for non-retention in the previous study) was reduced from one month to one week. In August 2012, the study was repeated to assess the effect of reducing TAT on improving retention one year after patients were placed on POV. Methods: A cohort analysis of data from patients in August 2011 and in August 2012 on POV was done. We compared retention on POV before and after reducing the TAT for laboratory results. Results: Retention on POV was 12.0% (95% CI 9.50-14.7) among 619 patients in 2011, (70% Females) ,mean age was 33years, Standard Deviation (S.D) 8.5 compared to 11.1% (95% CI 9.15-13.4) among 888 patients(70% Females), mean age 38.3 years, S.D 8.9 in 2012 (P=0.59). The main reasons for non-retention on the POV program in 2012 were poor adherence to ART (23%) and missed clinic appointments (14%). Conclusion and Recommendations: Reducing TAT for laboratory test results did not improve retention of stable HIV-infected adults on POV in our clinic. Strategies for improving adherence to ART and keeping clinic appointments need to be employed to balance workload and management of patients without compromising quality of care, patients` clinical, immunological and adherence outcome.
References Callanghan M, et al (2010), Human Resource Health doi: 10.1186/1478-4491-8-8 Samb B, et al, N Engl J Med 2007; 357:2510- 2514 Morris MB, et al (2009), BMC Health Serv Res.doi:10.1186/1472-6963-9-5
Track Descriptors 500 Track E: HIV and health system strengthening – E1.Leveraging the AIDS response to strengthen health systems and improve other health outcomes
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Authors of the Abstract
Maselle, Edna, Makerere University Joint AIDS Program (MJAP), Uganda (Presenting); Muhanguzi, A., Asaph, Makerere University Joint AIDS Program (MJAP), Uganda; Muhumuza, S., Simon, Makerere University Joint AIDS Program (MJAP), Uganda; Nansubuga, J., Jennifer, Makerere University Joint AIDS Program (MJAP), Uganda; Nawavvu, C., Cecilia, Makerere University Joint AIDS Program (MJAP), Uganda; Namusobya, J., Jennifer, Makerere University Joint AIDS Program (MJAP), Uganda; Kamya, M.R., Moses, Makerere University Joint AIDS Program (MJAP), Department of Medicine, Makerere University , Uganda; Semitata, F.C., Fred, Makerere University Joint AIDS Program (MJAP), Department of Medicine, Makerere University, Uganda