Academic detailing: a knowledge translation strategy to implement HIV Clinical Management Guideline

Session: 

Oral session: Knowledge translation and communicating evidence (6)

Date: 

Monday 17 September 2018 - 14:00 to 14:10

Location: 

Pentland Auditorium

All authors in correct order:

Bones AA1, Cazella S2, Stein A2
1 Secretaria Municipal de Saúde de Porto Alegre and Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
2 Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
Presenting author and contact person

Presenting author:

Airton Stein

Contact person:

Airton Stein
Abstract text
Background: The 90-90-90 treatment targets intend to resolve the HIV epidemic by 2030 through treatment to suppress the viral charge. HIV infection has been regarded as a chronic disease, and there is a need to recommend antiretroviral therapy as soon as possible, regardless of the CD4 count (a cell type that fights infection). In this context, the management of HIV treatment should be handled by a Primary Care Provider (PCP), and there is a need to follow the strategies of the HIV/AIDS Guideline; those cases identified as more complex should be referred to a specialized care.

Objectives: To analyze implementation strategies of the HIV Clinical Management Guideline for PCPs.

Methods: A focus group consisting of 112 PCPs discussed their perception of educational strategies that are applied for the implementation of the Guideline. A series of implementation strategies were evaluated by PCPs, such as: sending a guideline by email, a formal lecture provided by an expert on HIV, questions and answers that had been arisen during a consultation via cell phone , and academic detailing.

Results: PCPs identified that customized interventions would be the best strategy in order to overcome the barriers to implement the HIV/Aids Guideline in primary care. All 112 PCPs identified that educating physicians in their offices is a promising strategy for changing medical practice, mainly through academic detailing, an intervention that combines interactive, one-on-one communication conducted by trained healthcare professionals.

Conclusions: Academic detailing should be a choice for knowledge translation, as it enables behaviour change, specially those performances that are based on local cultural, and most likely not based on scientific evidence. A randomized clinical trial is essential to evaluate the effectiveness of this approach for defining a health policy in HIV/AIDS in low- and middle-income countries.

Patient or healthcare consumer involvement: The research protocol of a randomized clinical trial on academic detailing as an implementation strategy for the HIV Clinical Management Guideline was evaluated by the Ethical Board, which includes patient representatives.

Relevance to patients and consumers: 

There is a possibility to solve the HIV epidemic until 2030 through treatment that would suppress the viral charge. Academic detailing is a knowledge translation strategy to implement HIV Clinical Management Guideline and would be feasible to implement for primary care provider (PCP).