14th Annual Conference of the British HIV Association 23-25 April 2008, Belfast

OPTIONE - EVALUATION OF INNOVATIVE HIV OUTPATIENT MODEL SHOWS STANDARD OF CARE MAINTAINED WITH FEWER CLINIC VISITS AND GREATER SATISFACTION

HIV Med 2008; 9(Suppl. 1):10 (abstract no. P1)

KM Coyne, A Kerley, S Mandalia and AG McOwan
Chelsea and Westminster Hospital, London, UK

BACKGROUND: Clinics need to be accessible to an ever increasing number of adults living with HIV. We devised a model of care based on nurse-led review and phlebotomy. Results are reviewed by a doctor and patients notified by email. Information can be sent via web links or attachments, and patients can also make a doctor's appointment at any time. Patients are suitable for OptionE if they are stable on or off antiretroviral therapy with no unresolved medical issues.

METHODS: A retrospective case note review was performed of the first 100 patients enrolled on OptionE. Data regarding demographics, hepatitis B and C testing, virological failure and adherence assessment was compared to the general clinic cohort. Patients completed questionnaires about their satisfaction with clinical care at time on enrolling with OptionE and at least 12 months later. The two responses were compared and kappa statistics calculated.

RESULTS:Patients registering with OptionE did not differ from the general clinic cohort in gender or ethnicity but were significantly older (P < 0.001). Seventy three percent were on antiretroviral therapy and most opted for home delivery of medications. After 12 months 84% continued with OptionE. There were no virological failures. All patients had an annual adherence assessment and hepatitis B and C testing were significantly better than in general clinic (P < 0.001). OptionE attenders made a mean of 3.1 fewer clinic visits per year, and spent shorter time periods in clinic. They reported increased satisfaction with obtaining test results and medication, and said it was easier to access appointments.

DISCUSSION: OptionE increases patient choice and satisfaction, and reduces clinic visits. Our study suggests that clinical care is not compromised.

2008-04-23
P1

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