Swiss medical weekly最新文献

{"title":"Supplementum 277: Abstracts of the of the annual meeting of the Swiss Society of Paediatrics.","authors":"Swiss Society Of Paediatrics","doi":"10.57187/s.4002","DOIUrl":"10.57187/s.4002","url":null,"abstract":"","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"4002"},"PeriodicalIF":2.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multi-method approach to drafting candidate entrustable professional activities for a general internal medicine residency programme.","authors":"Matteo Monti, Valérie Pittet, Sonia Frick, David Gachoud","doi":"10.57187/s.3592","DOIUrl":"https://doi.org/10.57187/s.3592","url":null,"abstract":"<p><strong>Introduction: </strong>Entrustable professional activities (EPAs) are units of concrete daily clinical tasks that trainee physicians should be able to handle with increasing autonomy during their postgraduate training. EPAs are gaining international recognition as an essential component of competency-based medical training programmes. The process of developing EPAs for a nationwide training programme is complex and requires an in-depth understanding of EPAs as a concept and good knowledge of appropriate development processes. This article provides a detailed description of the methodology and results of a multi-step approach for developing a list of candidate EPAs for Switzerland's postgraduate training programme in general internal medicine (GIM).</p><p><strong>Methods: </strong>We took a multi-step approach including a systematic review of international literature, four national focus groups, a national consensus process using a RAND appropriateness method, and a quality check of the selected candidate EPAs using EQual criteria.</p><p><strong>Results: </strong>These steps generated a final list of 247 candidate EPAs in general internal medicine that were submitted for the national consensus process. After two rounds of rating, experts agreed on the appropriateness for general internal medicine postgraduate training of 225 candidate EPAs. Twenty-two were deemed inappropriate, and disagreement persisted only for two EPAs.</p><p><strong>Discussion: </strong>This multi-step programme is one of the few describing in detail the process of developing a list of EPAs and providing evidence of validity at each step. The clinical breadth of our candidate EPAs, together with the detailed description of our methodology, could serve as a useful starting point from which medical education specialists or clinicians could develop or revise applicable lists of EPAs, particularly for postgraduate training programmes in either general internal medicine or family medicine.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3592"},"PeriodicalIF":2.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141159202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supplementum 276: Abstracts of the of the 8th Annual Spring Congress of the Swiss Society of General Internal Medicine.","authors":"Swiss Society Of General Internal Medicine","doi":"10.57187/s.3896","DOIUrl":"https://doi.org/10.57187/s.3896","url":null,"abstract":"","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3896"},"PeriodicalIF":2.9,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician wellbeing and burnout in emergency medicine in Switzerland.","authors":"Eric P Heymann, Valerie Romann, Rod Lim, Kristine Van Aarsen, Nour Khatib, Thomas Sauter, Barbara Schild, Stefan Mueller","doi":"10.57187/s.3421","DOIUrl":"https://doi.org/10.57187/s.3421","url":null,"abstract":"<p><p>Emergency physicians are the most at-risk medical specialist group for burnout. Given its consequences for patient care and physician health and its resulting increased attrition rates, ensuring the wellbeing of emergency physicians is vital for preserving the integrity of the safety net for the healthcare system that is emergency medicine. In an effort to understand the current state of practicing physicians, this study reviews the results of the first national e-survey on physician wellbeing and burnout in emergency medicine in Switzerland. Addressed to all emergency physicians between March and April 2023, it received 611 complete responses. More than half of respondents met at least one criterion for burnout according to the Maslach Burnout Inventory - Human Services Survey (59.2%) and the Copenhagen Burnout Inventory (54.1%). In addition, more than half reported symptoms suggestive of mild to severe depression, with close to 20% screening positively for moderate to severe depression, nearly 4 times the incidence in the general population, according to the Patient Health Questionnaire-9. We found that 10.8% of respondents reported having considered suicide at some point in their career, with nearly half having considered this in the previous 12 months. The resulting high attrition rates (40.6% of respondents had considered leaving emergency medicine because of their working conditions) call into question the sustainability of the system. Coinciding with trends observed in other international studies on burnout in emergency medicine, this study reinforces the fact that certain factors associated with wellbeing are intrinsic to emergency medicine working conditions.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3421"},"PeriodicalIF":2.9,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of vaccination status with perceived discrimination in patients with COVID-19: results from a cross-sectional study.","authors":"Christoph Becker, Katharina Beck, Céline Moser, Clara Lessing, Armon Arpagaus, Sebastian Gross, Tabita Urben, Rainer Schaefert, Simon Amacher, Stefano Bassetti, Philipp Schuetz, Sabina Hunziker","doi":"10.57187/s.3634","DOIUrl":"https://doi.org/10.57187/s.3634","url":null,"abstract":"<p><strong>Study aims: </strong>During the COVID-19 pandemic, there was increasing pressure to be vaccinated to prevent further spread of the virus and improve outcomes. At the same time, part of the population expressed reluctance to vaccination, for various reasons. Only a few studies have compared the perceptions of vaccinated and non-vaccinated patients being treated in hospitals for COVID-19. Our aim was to investigate the association between vaccination status and perceived healthcare-associated discrimination in patients with COVID-19 receiving hospital treatment.</p><p><strong>Methods: </strong>Adult patients presenting to the emergency department or hospitalised for inpatient care due to or with COVID-19 from 1 June to 31 December 2021 in two Swiss hospitals were eligible. The primary endpoint was patients' perceived healthcare-associated discrimination, measured with the Discrimination in Medical Settings (DMS) scale. Secondary endpoints included different aspects of perceived quality of care and symptoms of psychological distress measured with the Hospital Anxiety and Depression Scale.</p><p><strong>Results: </strong>Non-vaccinated patients (n = 113) had significantly higher DMS scores compared to vaccinated patients (n = 80) (mean: 9.54 points [SD: 4.84] vs 7.79 points [SD: 1.85]; adjusted difference: 1.18 [95% CI: 0.04-2.33 points]) and 21 of 80 vaccinated patients felt discriminated against vs 54 of 113 non-vaccinated patients (adjusted OR: 2.09 [95% CI: 1.10-3.99 ]). Non-vaccinated patients reported lower scores regarding respectful treatment by the nursing team (mean: 8.39 points [SD: 2.39] vs 9.30 points [SD: 1.09]; adjusted difference: -0.6 [95% CI: -1.18 - -0.02 points]).</p><p><strong>Conclusion: </strong>We found an association between vaccination status and perceived healthcare-associated discrimination. Healthcare workers should act in a professional manner regardless of a patient's vaccination status; in doing so, they might prevent the creation of negative perceptions in patients.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3634"},"PeriodicalIF":2.9,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term levels of protection of different types of immunity against the Omicron variant: a rapid literature review.","authors":"Sabina Rodriguez Velásquez, Loza Estifanos Biru, Sandrine Marie Hakiza, Muaamar Al-Gobari, Isotta Triulzi, Jyoti Dalal, Camille Beatrice Gaza Varela, Sara Botero Mesa, Olivia Keiser","doi":"10.57187/s.3732","DOIUrl":"10.57187/s.3732","url":null,"abstract":"<p><strong>Introduction: </strong>With the emergence of newer SARS-CoV-2 variants and their substantial effects on the levels and duration of protection against infection, an understanding of these characteristics of the protection conferred by humoral and cellular immunity can aid in the proper development and implementation of vaccine and safety guidelines.</p><p><strong>Methods: </strong>We conducted a rapid literature review and searched five electronic databases weekly from 1 November 2021 to 30 September 2022. Studies that assessed the humoral or cellular immunity conferred by infection, vaccination or a hybrid (combination of both) in adults and risk groups (immunocompromised and older populations) were identified. Studies were eligible when they reported data on immunological assays of COVID-19 (related to vaccination and/or infection) or the effectiveness of protection (related to the effectiveness of vaccination and/or infection).</p><p><strong>Results: </strong>We screened 5103 studies and included 205 studies, of which 70 provided data on the duration of protection against SARS-CoV-2 infection. The duration of protection of adaptive immunity was greatly impacted by Omicron and its subvariants: levels of protection were low by 3-6 months from exposure to infection/vaccination. Although more durable, cellular immunity also showed signs of waning by 6 months. First and second mRNA vaccine booster doses increased the levels of protection against infection and severe disease from Omicron and its subvariants but continued to demonstrate a high degree of waning over time.</p><p><strong>Conclusion: </strong>All humoral immunities (infection-acquired, vaccine-acquired and hybrid) waned by 3-6 months. Cellular immunity was more durable but showed signs of waning by 6 months. Hybrid immunity had the highest magnitude of protection against SARS-CoV-2 infection. Boosting may be recommended as early as 3-4 months after the last dose, especially in risk groups.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3732"},"PeriodicalIF":2.1,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid detection of the source of a Listeria monocytogenes outbreak in Switzerland through routine interviewing of patients and whole-genome sequencing.","authors":"Cornelia Speich, Roger Stephan, Nicola Dhima, Florian Hollenstein, Jule Horlbog, Giulia Delvento, Ekkehardt Altpeter, Meike Zuske, Michelle Raess, Helena Greter","doi":"10.57187/s.3745","DOIUrl":"https://doi.org/10.57187/s.3745","url":null,"abstract":"<p><strong>Aims of the study: </strong>Listeriosis is a notifiable disease in Switzerland. In summer 2022, the Swiss Federal Office of Public Health noticed an increase in reports of listeriosis cases, indicating a possible ongoing outbreak. Here we present the approaches applied for rapidly confirming the outbreak, detecting the underlying source of infection and the measures put in place to eliminate it and contain the outbreak.</p><p><strong>Methods: </strong>For close surveillance and early detection of outbreak situations with their possible sources, listeriosis patients in Switzerland are systematically interviewed about risk behaviours and foods consumed prior to the infection. Listeria monocytogenes isolates derived from patients in medical laboratories are sent to the National Reference Laboratory for Enteropathogenic Bacteria and Listeria, where they routinely undergo whole-genome sequencing. Interview and whole-genome sequencing data are continuously linked for comparison and analysis.</p><p><strong>Results: </strong>In summer 2022, 20 patient-derived L. monocytogenes serotype 4b sequence type 388 strains were found to belong to an outbreak cluster (≤10 different alleles between neighbouring isolates) based on core genome multilocus sequence typing analysis. Geographically, 18 of 20 outbreak cases occurred in northeastern Switzerland. The median age of patients was 77.4 years (range: 58.1-89.7), with both sexes equally affected. Rolling analysis of the interview data revealed smoked trout from a local producer as a suspected infection source, triggering an on-site investigation of the production facility and sampling of the suspected products by the responsible cantonal food inspection team on 15 July 2022. Seven of ten samples tested positive for L. monocytogenes and the respective cantonal authority ordered a ban on production and distribution as well as a product recall. The Federal Food Safety and Veterinary Office released a nationwide public alert covering the smoked fish products concerned. Whole-genome sequencing analysis confirmed the interrelatedness of the L. monocytogenes smoked trout product isolates and the patient-derived isolates. Following the ban on production and distribution and the product recall, reporting of new outbreak-related cases rapidly dropped to zero.</p><p><strong>Conclusions: </strong>This listeriosis outbreak could be contained within a relatively short time thanks to identification of the source of contamination through the established combined approach of timely interviewing of every listeriosis patient or a representative and continuous molecular analysis of the patient- and food-derived L. monocytogenes isolates. These findings highlight the effectiveness of this well-established, joint approach involving the federal and cantonal authorities and the research institutions mandated to contain listeriosis outbreaks in Switzerland.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3745"},"PeriodicalIF":2.9,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allogeneic haematopoietic cell transplantation for chronic myeloid leukaemia in Switzerland in the face of rapid development of effective drugs.","authors":"Dominik Heim, Helen Baldomero, Michael Medinger, Stavroula Masouridi-Levrat, Urs Schanz, Gayathri Nair, Tayfun Güngör, Jörg Halter, Jakob R Passweg, Yves Chalandon","doi":"10.57187/s.3754","DOIUrl":"https://doi.org/10.57187/s.3754","url":null,"abstract":"<p><strong>Aim: </strong>Until the year 2000, allogeneic haematopoietic cell transplantation (HCT) was the standard treatment for young and fit chronic myeloid leukaemia (CML) patients. CML was the main indication for allogeneic HCT. The introduction of tyrosine kinase inhibitors changed the treatment of CML patients dramatically. Allogeneic HCT was rapidly replaced by tyrosine kinase inhibitors as first-line treatment for CML, and the indication shifted to the treatment of non-responders, patients intolerant to tyrosine kinase inhibitors and patients whose CML is transforming to the accelerated phase and blast crisis. This paper describes changes in the use of transplantation technology for CML patients in the face of rapid drug development.</p><p><strong>Methods: </strong>All patients receiving a transplant for CML between 1997 and 2021 in Switzerland were included in the study. For the purpose of this analysis, time periods were analysed in quinquennia, 1997-2001 (Q1), 2002-2006 (Q2), 2007-2011 (Q3), 2012-2016 (Q4) and 2017-2021 (Q5), as the observation period spanned 25 years.</p><p><strong>Results: </strong>Overall, 239 patients received a transplant. These included 96 in Q1, 56 in Q2, 25 in Q3, 34 in Q4 and 28 in Q5. Patient characteristics changed over time: recent patients were older and had a longer interval from diagnosis to transplantation because of tyrosine kinase inhibitor treatment. However, the proportions of patients receiving transplants during an early versus advanced disease stage differed little. Transplant technology changed, as well. Patients received intensive conditioning regimens less often due to higher age and more commonly had peripheral blood as opposed to bone marrow transplants. However, the type of stem cell donor selected did not differ. In a univariable analysis, there were no significant differences in survival, progression-free survival, non-relapse mortality, relapse incidence or incidences of acute and chronic graft-versus-host disease among the five quinquennia. In a multivariable analysis, older age, donors other than HLA-identical siblings and more advanced disease stage, but not the quinquennium, were associated with higher risk of death.</p><p><strong>Conclusion: </strong>Since the introduction of tyrosine kinase inhibitors haematopoietic cell transplantation has been used less frequently to treat CML. Patients in recent cohorts received transplants at an older age and later in the disease course; despite these higher risks, the outcome of allogeneic HCT has not worsened over time but has not improved, either. As the outcome is worse in advanced phases, it is important to conduct transplants before disease progression. Therefore, patients with advanced disease should be monitored closely and receive transplants in time.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3754"},"PeriodicalIF":2.9,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of and risk factors for suicidal ideation in adolescents during the COVID-19 pandemic: a cross-sectional study.","authors":"Roxane Dumont, Elsa Lorthe, Viviane Richard, Andrea Loizeau, Guillaume Fernandez, David De Ridder, Francesco Pennacchio, Julien Lamour, María-Eugenia Zaballa, Helene Baysson, Klara M Posfay-Barbe, Remy P Barbe, Silvia Stringhini, Idris Guessous","doi":"10.57187/s.3461","DOIUrl":"https://doi.org/10.57187/s.3461","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pandemic-related life changes may have had a deleterious impact on suicidal behaviours. Early detection of suicidal ideation and identification of subgroups at increased risk could help prevent suicide, one of the leading causes of death among adolescents worldwide. Here, we aimed to investigate the prevalence of and risk factors for suicidal ideation in adolescents using a population-based sample from Switzerland, two years into the pandemic.</p><p><strong>Methods: </strong>Between December 2021 and June 2022, adolescents aged 14 to 17 years already enrolled in a population-based cohort study (State of Geneva, Switzerland) were asked about suicidal ideation over the previous year. In addition to a regression model, we conducted a network analysis of exposures which identified direct and indirect risk factors for suicidal ideation (i.e. those connected through intermediate risk factors) using mixed graphical models.</p><p><strong>Results: </strong>Among 492 adolescents, 14.4% (95% CI: 11.5-17.8) declared having experienced suicidal ideation over the previous year. Using network analysis, we found that high psychological distress, low self-esteem, identifying as lesbian, gay or bisexual, suffering from bullying, extensive screen time and a severe COVID-19 pandemic impact were major risk factors for suicidal ideation, with parent-adolescent relationship having the highest centrality strength in the network.</p><p><strong>Conclusion: </strong>Our results show that a significant proportion of adolescents experience suicidal ideation, yet these rates are comparable with pre-pandemic results. Providing psychological support is fundamental, with a focus on improving parent-adolescent relationships.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3461"},"PeriodicalIF":2.9,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Costs and acceptability of simplified monitoring in HIV-suppressed patients switching to dual therapy: the SIMPL'HIV open-label, factorial randomised controlled trial.","authors":"Annalisa Marinosci, Delphine Sculier, Gilles Wandeler, Sabine Yerly, Marcel Stoeckle, Enos Bernasconi, Dominique L Braun, Pietro Vernazza, Matthias Cavassini, Marta Buzzi, Karin J Metzner, Laurent Decosterd, Huldrych F Günthard, Patrick Schmid, Andreas Limacher, Mattia Branca, Alexandra Calmy","doi":"10.57187/s.3762","DOIUrl":"10.57187/s.3762","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Clinical and laboratory monitoring of patients on antiretroviral therapy is an integral part of HIV care and determines whether treatment needs enhanced adherence or modification of the drug regimen. However, different monitoring and treatment strategies carry different costs and health consequences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;The SIMPL'HIV study was a randomised trial that assessed the non-inferiority of dual maintenance therapy. The co-primary outcome was a comparison of costs over 48 weeks of dual therapy with standard antiretroviral therapy and the costs associated with a simplified HIV care approach (patient-centred monitoring [PCM]) versus standard, tri-monthly routine monitoring. Costs included outpatient medical consultations (HIV/non-HIV consultations), non-medical consultations, antiretroviral therapy, laboratory tests and hospitalisation costs. PCM participants had restricted immunological and blood safety monitoring at weeks 0 and 48, and they were offered the choice to complete their remaining study visits via a telephone call, have medications delivered to a specified address, and to have blood tests performed at a location of their choice. We analysed the costs of both strategies using invoices for medical consultations issued by the hospital where the patient was followed, as well as those obtained from health insurance companies. Secondary outcomes included differences between monitoring arms for renal function, lipids and glucose values, and weight over 48 weeks. Patient satisfaction with treatment and monitoring was also assessed using visual analogue scales.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 93 participants randomised to dolutegravir plus emtricitabine and 94 individuals to combination antiretroviral therapy (median nadir CD4 count, 246 cells/mm3; median age, 48 years; female, 17%),patient-centred monitoring generated no substantial reductions or increases in total costs (US$ -421 per year [95% CI -2292 to 1451]; p = 0.658). However, dual therapy was significantly less expensive (US$ -2620.4 [95% CI -2864.3 to -2331.4]) compared to standard triple-drug antiretroviral therapy costs. Approximately 50% of participants selected one monitoring option, one-third chose two, and a few opted for three. The preferred option was telephone calls, followed by drug delivery. The number of additional visits outside the study schedule did not differ by type of monitoring. Patient satisfaction related to treatment and monitoring was high at baseline, with no significant increase at week 48.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patient-centred monitoring did not reduce costs compared to standard monitoring in individuals switching to dual therapy or those continuing combined antiretroviral therapy. In this representative sample of patients with suppressed HIV, antiretroviral therapy was the primary factor driving costs, which may be reduced by using generic drugs to mitigate the high cost of li","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3762"},"PeriodicalIF":2.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}