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Nurse-centred HIV care as effective as doctor's care

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Nurse-centred care of HIV patients can be just as effective as care provided by doctors and offers some particular benefits, according to a joint UK and South African study.

There was no negative impact on survival rates or virus suppression when nurses rather than doctors administered antiretroviral drugs, research published in The Lancet showed.

Researchers from the University of East Anglia (UEA) and the University of Cape Town collaborated with other universities on the project, in which 15,000 patients taking part in a two-year randomised controlled trial in Free State, South Africa.

The scientists observed a number of health benefits among patients in the nurse-focused care, including significantly improved detection of tuberculosis, increased white blood cell count, increased weight, considerably improved tuberculosis detection rates and better compliance with the treatment programme.

It is the first time that researchers have investigated the impact of “task-shifting” from doctors to nurses on such a large scale.

Although the project was solely carried out in South Africa, it may also have significance for clinicians in the West where it is specialist doctors who typically administer antiretroviral treatment.

“Our findings show that with very little extra training and support nurses can deliver HIV care that is just as safe and effective as that provided by doctors,” said joint lead author Professor Max Bachmann, of Norwich Medical School at UEA.

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