A trial into “task-shifting” from doctors to nurses in HIV care has proved a success, according to an article in the medical journal The Lancet.
Researchers on the study found that antiretroviral therapy (ART) by trained nurses in primary care was just as safe and effective as doctor monitored care.
Between 2005 and 2007, 812 patients with HIV in South Africa were assigned ART care by nurses (408) or doctors (404).
Of the patients treated by nurses, 192 (48%) experienced treatment failure, while there was a similar number, 179 (44%), in those treated by doctors.
At the end of the two-year study, researchers found there had been 10 deaths in those treated by nurses, compared with 11 treated by doctors.
There were 44 viral failures in those treated by nurses, and 39 by those who received care from doctors, while toxicity failures amounted to 68 and 66 respectively.
According to the article, the task-shifting success could ease the critical shortage of healthcare workers, while expanding access to ART care to millions of people across the world.
Currently, there is a global shortage of 4.3 million health workers, which prompted the World Health Organisation to propose task-shifting from doctors to lower level healthcare workers.
The authors of the study said the findings “lend support to the strategy of task-shifting, and suggest that HIV management by nurses can be safe and effective, probably even for those starting therapy with advanced HIV infection”.
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