Task shifting of antiretroviral treatment from doctors to primary-care nurses in South Africa (STRETCH): a pragmatic, parallel, cluster-randomised trial

Lara Fairall, Max Bachmann, Carl Lombard, Venessa Timmerman, Kerry Uebel, Merrick Zwarenstein, Andrew Boulle, Daniella Georgeu, Christopher J Colvin, Simon Lewin, Gill Faris, Ruth Cornick, Beverly Draper, Mvula Tshabalala, Eduan Kotze, Cloete van Vuuren, Dewald Steyn, Ronald Chapman, Eric Bateman

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Abstract

Robust evidence of the effectiveness of task shifting of antiretroviral therapy (ART) from doctors to other health workers is scarce. We aimed to assess the effects on mortality, viral suppression, and other health outcomes and quality indicators of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) programme, which provides educational outreach training of nurses to initiate and represcribe ART, and to decentralise care.
Original languageEnglish
Pages (from-to)889-898
Number of pages9
JournalLancet
Volume380
Issue number9845
DOIs
Publication statusPublished - 8 Sep 2012

Keywords

  • Anti-HIV Agents
  • Humans
  • Primary Health Care
  • CD4 Lymphocyte Count
  • Viral Load
  • HIV Infections
  • Adult
  • Primary Care Nursing
  • Treatment Outcome
  • Delivery of Health Care
  • Middle Aged
  • South Africa
  • Drug Prescriptions
  • Female
  • Male

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