Nurses as good as doctors in AIDS care monitoring

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Nurses are as good as doctors at monitoring treatment for AIDS patients, and shifting this role to them could help ease a critical shortage of health workers, experts said on Wednesday.

A study into so-called “task-shifting” in HIV care in South Africa found virtually no difference in outcomes for patients taking AIDS drugs under the care of a nurse or a doctor.

South Africa, where HIV/AIDS kills an estimated 1,000 people a day, has the world’s largest national programme of treatment with antiretroviral drugs, but has only 17.4 medical practitioners for every 100,000 people, according to the study.

The United Nations estimates that 33 million people around the world are infected with the human immunodeficiency virus (HIV) that causes AIDS, and more than half of the 9.5 million people who need AIDS drugs cannot get them.

That problem is compounded by a global shortage of 4.3 million healthcare workers.

The World Health Organisation recently proposed “task-shifting” from doctors to other health-care workers.

To see if this strategy would pay off, a team from the Comprehensive International Program for Research in AIDS in South Africa compared the outcomes of nurse versus doctor management for patients in two clinics between 2005 and 2007.

They found that 48 percent of patients had treatment failure in the nurse group, compared with 44 percent in the doctor group. After two years, deaths and outcomes such as drug toxicity side effects or drop-out were also similar.

SOURCE:  Lancet, online June 16, 2010.

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