Optimised Electronic Patient Records to Improve Clinical Monitoring of HIV-positive Patients in Rural South Africa (MONART)
HIV Infections
About this trial
This is an interventional health services research trial for HIV Infections focused on measuring HIV, HIV viral load, HIV drug resistance, Treatment failure, Virological suppression
Eligibility Criteria
Inclusion Criteria:
- All nursing care staff employed at the health facilities are eligible for inclusion to receive the quality improvement intervention
- Willing to provide informed consent
- Work in one of the ten facilities randomised for the study
- Involved in HIV patient care
- Patients receiving care from participating clinics must be aged 16 years and above to be included in the study
Exclusion Criteria:
- Expecting to relocate or change jobs during the study duration
- Unwilling or unable to provide informed consent/refusal to participate
Sites / Locations
- Africa Health Research Institute
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Intervention arm
Control arm
Quality improvement package Identification of a viral load champion whose role will include tracing and recalling patients who need further assessments of their VL or switch to second-line regimen. QIP to address process and clinic impediments to VLM as well as training in antiretroviral treatment monitoring guidelines Training in the use of enhanced TIER.Net technology developed as part of the trial and how to access reports on the dashboard system. Augmentation of TIER.Net with a dashboard system VL results will be imported into TIER.Net daily from the National Health Laboratory Service which will be linked to patients in TIER.Net based on multiple exclusive and linked deterministic rules using a combination of variables such as name, surname, sex, date of birth, date of visit, NHLS lab number, facility and folder number. The information contained in TIER.Net will be used to develop a dashboard which summarises viral load data at individual and clinic level.
Viral load results are manually captured on to the TIER.Net system with filing of the paper results in patients' clinical notes for nurses' review during routine appointments. This is used to produce a monthly enrolment and quarterly cohort reports for the central monitoring of the ART programme.