Choice-architecture TB preventive therapy prescribing for HIV patients in Mozambique.

IF 1.3 Q4 RESPIRATORY SYSTEM

Public Health Action Pub Date : 2025-03-01 DOI:10.5588/pha.24.0033

I Salles, S Munguambe, R Chiau, E Valverde, J E Golub, C J Hoffmann, K Shearer

{"title":"Choice-architecture TB preventive therapy prescribing for HIV patients in Mozambique.","authors":"I Salles, S Munguambe, R Chiau, E Valverde, J E Golub, C J Hoffmann, K Shearer","doi":"10.5588/pha.24.0033","DOIUrl":null,"url":null,"abstract":"Introduction: Despite the effectiveness of TB preventive treatment (TPT) in reducing TB incidence and mortality among people living with HIV (PLHIV), uptake has been low. We conducted a cluster randomised trial to evaluate a choice architecture-based intervention for prescribing TPT (the 'CAT' study) to PLHIV in Mozambique, nested within the short-course 3HP regimen roll-out, and qualitatively assessed intervention acceptability and feasibility with healthcare workers (HCWs).Methods: The CAT intervention comprised training on default TPT prescribing and prescribing stickers integrated into antiretroviral therapy (ART) stationery. We assessed intervention acceptability and feasibility to increase TPT prescribing through 25 in-depth interviews (IDIs) with HCWs from participating clinics between August and September 2022. Thematic analysis of the IDIs identified key themes.Results: Participants reported a positive impact of the intervention on patient care, though workload opinions varied. Participants reported that CAT did not significantly alter routine TPT prescribing processes but highlighted the need for reminders and decision-support tools. CAT was viewed to streamline patient management, particularly identifying eligible TPT patients and simplifying documentation.Conclusion: The CAT strategy could enhance TPT delivery to PLHIV and integrate it into preventive care for other diseases.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 1","pages":"21-25"},"PeriodicalIF":1.3000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841113/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health Action","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5588/pha.24.0033","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Despite the effectiveness of TB preventive treatment (TPT) in reducing TB incidence and mortality among people living with HIV (PLHIV), uptake has been low. We conducted a cluster randomised trial to evaluate a choice architecture-based intervention for prescribing TPT (the 'CAT' study) to PLHIV in Mozambique, nested within the short-course 3HP regimen roll-out, and qualitatively assessed intervention acceptability and feasibility with healthcare workers (HCWs).

Methods: The CAT intervention comprised training on default TPT prescribing and prescribing stickers integrated into antiretroviral therapy (ART) stationery. We assessed intervention acceptability and feasibility to increase TPT prescribing through 25 in-depth interviews (IDIs) with HCWs from participating clinics between August and September 2022. Thematic analysis of the IDIs identified key themes.

Results: Participants reported a positive impact of the intervention on patient care, though workload opinions varied. Participants reported that CAT did not significantly alter routine TPT prescribing processes but highlighted the need for reminders and decision-support tools. CAT was viewed to streamline patient management, particularly identifying eligible TPT patients and simplifying documentation.

Conclusion: The CAT strategy could enhance TPT delivery to PLHIV and integrate it into preventive care for other diseases.

查看原文本刊更多论文

导言：尽管结核病预防性治疗（TPT）能有效降低艾滋病病毒感染者（PLHIV）的结核病发病率和死亡率，但其接受率却很低。我们在莫桑比克开展了一项群组随机试验，以评估基于选择架构的TPT处方干预措施（"CAT "研究），该干预措施嵌套在短程3HP治疗方案中，并对医护人员（HCWs）的干预措施可接受性和可行性进行了定性评估：CAT干预措施包括默认TPT处方培训和纳入抗逆转录病毒疗法（ART）文具的处方贴纸。我们在 2022 年 8 月至 9 月期间对参与诊所的医护人员进行了 25 次深入访谈 (IDI)，评估了增加 TPT 处方的干预措施的可接受性和可行性。对深度访谈进行的主题分析确定了关键主题：结果：参与者报告称，干预措施对患者护理产生了积极影响，但工作量意见不一。参与者报告称，CAT 并未显著改变 TPT 的常规处方流程，但强调了对提醒和决策支持工具的需求。与会者认为计算机辅助治疗可简化患者管理，特别是识别符合条件的 TPT 患者和简化文件记录：计算机辅助治疗策略可加强对艾滋病毒感染者的 TPT 治疗，并将其纳入其他疾病的预防保健中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Public Health Action RESPIRATORY SYSTEM-

自引率

0.00%

发文量

期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.