Academic detailing as a strategy to implement a HIV guideline in primary health care




Poster session 2


Monday 17 September 2018 - 12:30 to 14:00

All authors in correct order:

Bones AA1, Cazella SC2, Stein AT2
1 Health Department, Federal University of Health Sciences of Porto Alegre, Brazil
2 Federal University of Health Sciences of Porto Alegre, Brazil
Presenting author and contact person

Presenting author:

Airton Stein

Contact person:

Abstract text
Background: There are several HIV guidelines, based on the age group and clinical condition of the patient. After the START study, the primary health care approach to HIV care is a new challenge, especially for those patients who are asymptomatic and have a CD4 count higher than 350, and in settings where there is a high incidence rate of HIV. There is a need to identify new strategies.

Objectives: To identify the importance of implementing an academic detailing (AD) strategy for the clinical application of an HIV guideline in primary care.

Methods: This study is based on an extensive literature review of the use of AD for HIV programmes in low- and middle-income countries (LMIC). We describe the steps used to deliver an HIV programme.

Results: There are seven steps in the programme: 1) identification of the difficulties in adherence to the protocol using a questionnaire; 2) elaboration of a manual for rapid consultation on the main evidence and development of the object of learning based on the evidence related to the guideline; 3) training the facilitators responsible for educational outreach; 4) defining the goal in order to begin anti-retroviral therapy as soon as possible in patients who have a CD4 count of 350 or more; 5) prescriber visiting for AD once a month for three months; 6) virtual assistance if there is any doubt and 7) follow-up of the results.

Conclusions: In South America, there are few publications on AD but it is regarded as a very low cost strategy for implementation of a guideline. This could overcome gaps in strategies for the implementation of new guidelines for HIV in primary health care.

Patient or healthcare consumer involvement: This study has been approved by the Ethical Committee of the University: a representative of patients is one of the members of this committee.

Relevance to patients and consumers: 

For patients it is essential to learn how to implement academic detail (AD) strategy for the clinical management of HIV guideline in primary care.