The Experts below are selected from a list of 255 Experts worldwide ranked by ideXlab platform
Raymond Bitchong - One of the best experts on this subject based on the ideXlab platform.
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integrating cardiovascular disease Risk Factor Screening into hiv services in swaziland lessons from an implementation science study
AIDS, 2018Co-Authors: Miriam Rabkin, Anton Palma, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Harriet Nuwagababiribonwoha, Pido Bongomin, V Okello, Raymond Bitchong, Wafaa ElsadrAbstract:OBJECTIVE To study the feasibility of cardiovascular disease Risk Factor (CVDRF) Screening at an HIV clinic in Swaziland. METHODS A sample of HIV-positive patients at least 40 years on antiretroviral treatment was screened for hypertension, diabetes, hyperlipidemia, and tobacco smoking. RESULTS A total of 1826 patients were screened; 684 (39%) had at least one CVDRF. Screening volume varied markedly, and was limited by staffing, space, and supplies. DISCUSSION CVDRF Screening was feasible and prevalence of Risk Factors in people living with HIV at least 40 years was high.
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A time-motion study of cardiovascular disease Risk Factor Screening integrated into HIV clinic visits in Swaziland.
Journal of the International AIDS Society, 2018Co-Authors: Anton Palma, Miriam Rabkin, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Pido Bongomin, V Okello, Raymond Bitchong, Harriet Nuwagaba-biribonwoha, Wafaa El-sadrAbstract:INTRODUCTION Screening of modifiable cardiovascular disease (CVD) Risk Factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of Screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of Screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. METHODS A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without Screening and measured time spent on HIV and CVD Risk Factor Screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with Screening. RESULTS We observed 172 patient visits (122 with CVD Risk Factor Screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p
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a time motion study of cardiovascular disease Risk Factor Screening integrated into hiv clinic visits in swaziland
Journal of the International AIDS Society, 2018Co-Authors: Anton Palma, Miriam Rabkin, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Harriet Nuwagababiribonwoha, Pido Bongomin, V Okello, Raymond BitchongAbstract:INTRODUCTION Screening of modifiable cardiovascular disease (CVD) Risk Factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of Screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of Screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. METHODS A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without Screening and measured time spent on HIV and CVD Risk Factor Screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with Screening. RESULTS We observed 172 patient visits (122 with CVD Risk Factor Screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p < 0.01). Time spent on HIV care was not affected: 4 (2 to 10) versus 4 (2 to 11) (p = 0.57). We recruited 126 patients for exit interviews, all of whom indicated that they would recommend Screening to others. CONCLUSION Provision of CVD Risk Factor Screening more than tripled the length of routine HIV clinic visits but did not reduce the time spent on HIV services. Programme managers need to take longer visit duration into account in order to effectively integrate CVD Risk Factor Screening and counselling into HIV programmes.
Margaret L Mcnairy - One of the best experts on this subject based on the ideXlab platform.
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integrating cardiovascular disease Risk Factor Screening into hiv services in swaziland lessons from an implementation science study
AIDS, 2018Co-Authors: Miriam Rabkin, Anton Palma, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Harriet Nuwagababiribonwoha, Pido Bongomin, V Okello, Raymond Bitchong, Wafaa ElsadrAbstract:OBJECTIVE To study the feasibility of cardiovascular disease Risk Factor (CVDRF) Screening at an HIV clinic in Swaziland. METHODS A sample of HIV-positive patients at least 40 years on antiretroviral treatment was screened for hypertension, diabetes, hyperlipidemia, and tobacco smoking. RESULTS A total of 1826 patients were screened; 684 (39%) had at least one CVDRF. Screening volume varied markedly, and was limited by staffing, space, and supplies. DISCUSSION CVDRF Screening was feasible and prevalence of Risk Factors in people living with HIV at least 40 years was high.
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A time-motion study of cardiovascular disease Risk Factor Screening integrated into HIV clinic visits in Swaziland.
Journal of the International AIDS Society, 2018Co-Authors: Anton Palma, Miriam Rabkin, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Pido Bongomin, V Okello, Raymond Bitchong, Harriet Nuwagaba-biribonwoha, Wafaa El-sadrAbstract:INTRODUCTION Screening of modifiable cardiovascular disease (CVD) Risk Factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of Screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of Screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. METHODS A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without Screening and measured time spent on HIV and CVD Risk Factor Screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with Screening. RESULTS We observed 172 patient visits (122 with CVD Risk Factor Screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p
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a time motion study of cardiovascular disease Risk Factor Screening integrated into hiv clinic visits in swaziland
Journal of the International AIDS Society, 2018Co-Authors: Anton Palma, Miriam Rabkin, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Harriet Nuwagababiribonwoha, Pido Bongomin, V Okello, Raymond BitchongAbstract:INTRODUCTION Screening of modifiable cardiovascular disease (CVD) Risk Factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of Screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of Screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. METHODS A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without Screening and measured time spent on HIV and CVD Risk Factor Screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with Screening. RESULTS We observed 172 patient visits (122 with CVD Risk Factor Screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p < 0.01). Time spent on HIV care was not affected: 4 (2 to 10) versus 4 (2 to 11) (p = 0.57). We recruited 126 patients for exit interviews, all of whom indicated that they would recommend Screening to others. CONCLUSION Provision of CVD Risk Factor Screening more than tripled the length of routine HIV clinic visits but did not reduce the time spent on HIV services. Programme managers need to take longer visit duration into account in order to effectively integrate CVD Risk Factor Screening and counselling into HIV programmes.
Anton Palma - One of the best experts on this subject based on the ideXlab platform.
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integrating cardiovascular disease Risk Factor Screening into hiv services in swaziland lessons from an implementation science study
AIDS, 2018Co-Authors: Miriam Rabkin, Anton Palma, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Harriet Nuwagababiribonwoha, Pido Bongomin, V Okello, Raymond Bitchong, Wafaa ElsadrAbstract:OBJECTIVE To study the feasibility of cardiovascular disease Risk Factor (CVDRF) Screening at an HIV clinic in Swaziland. METHODS A sample of HIV-positive patients at least 40 years on antiretroviral treatment was screened for hypertension, diabetes, hyperlipidemia, and tobacco smoking. RESULTS A total of 1826 patients were screened; 684 (39%) had at least one CVDRF. Screening volume varied markedly, and was limited by staffing, space, and supplies. DISCUSSION CVDRF Screening was feasible and prevalence of Risk Factors in people living with HIV at least 40 years was high.
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A time-motion study of cardiovascular disease Risk Factor Screening integrated into HIV clinic visits in Swaziland.
Journal of the International AIDS Society, 2018Co-Authors: Anton Palma, Miriam Rabkin, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Pido Bongomin, V Okello, Raymond Bitchong, Harriet Nuwagaba-biribonwoha, Wafaa El-sadrAbstract:INTRODUCTION Screening of modifiable cardiovascular disease (CVD) Risk Factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of Screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of Screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. METHODS A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without Screening and measured time spent on HIV and CVD Risk Factor Screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with Screening. RESULTS We observed 172 patient visits (122 with CVD Risk Factor Screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p
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a time motion study of cardiovascular disease Risk Factor Screening integrated into hiv clinic visits in swaziland
Journal of the International AIDS Society, 2018Co-Authors: Anton Palma, Miriam Rabkin, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Harriet Nuwagababiribonwoha, Pido Bongomin, V Okello, Raymond BitchongAbstract:INTRODUCTION Screening of modifiable cardiovascular disease (CVD) Risk Factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of Screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of Screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. METHODS A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without Screening and measured time spent on HIV and CVD Risk Factor Screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with Screening. RESULTS We observed 172 patient visits (122 with CVD Risk Factor Screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p < 0.01). Time spent on HIV care was not affected: 4 (2 to 10) versus 4 (2 to 11) (p = 0.57). We recruited 126 patients for exit interviews, all of whom indicated that they would recommend Screening to others. CONCLUSION Provision of CVD Risk Factor Screening more than tripled the length of routine HIV clinic visits but did not reduce the time spent on HIV services. Programme managers need to take longer visit duration into account in order to effectively integrate CVD Risk Factor Screening and counselling into HIV programmes.
Philip S. Lewis - One of the best experts on this subject based on the ideXlab platform.
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deprivation status and mid term change in blood pressure total cholesterol and smoking status in middle life a cohort study
European Journal of Preventive Cardiology, 2007Co-Authors: Georgios Lyratzopoulos, Richard F Heller, Margaret Hanily, Philip S. LewisAbstract:BACKGROUND: Individuals of lower socioeconomic status have an adverse cardiovascular disease Risk Factor profile. We examined whether deprivation status influences within-individual change over time in blood pressure (BP), cholesterol and smoking status during middle life. METHODS: Records of participants of a primary care-based cardiovascular disease Risk Factor Screening programme who were aged 35-55 years and had a first Screening episode between 1989 and 1993 and a subsequent Screening episode, were analysed. Deprivation status was defined using quintiles of the Townsend score. Using regression, mean annual change in BP, and total cholesterol was calculated for each deprivation group; and the effect of deprivation group status was examined. The probability of quitting smoking was also examined by deprivation group. RESULTS: Of all participants, 13,812 (72.1%) men and 16 932 (77.0%) women had complete follow-up (i.e. two Screening episodes). Mean annual increase in systolic BP was significantly greater with increasing deprivation group [by +0.24 and +0.28 mmHg/incremental deprivation group in men and women, respectively (95% confidence interval: +0.09 to +0.39 men, and +0.13 to +0.42 women)]. Deprivation status did not influence change in cholesterol (P=0.620, men, P=0.289, women). The probability of quitting smoking was significantly greater with increasing deprivation group in women [odds ratio 1.06 (95% confidence interval: 1.01-1.12)], but no effect was observed in men (P=0.389). DISCUSSION: The results are suggestive of a 'mixed' picture of widening (e.g. systolic and diastolic BP) as well as narrowing (e.g. smoking in women) socioeconomic inequalities in cardiovascular Risk Factor inequalities.
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Deprivation and trends in blood pressure, cholesterol, body mass index and smoking among participants of a UK primary-care based cardiovascular Risk Factor Screening programme: Both narrowing and widening in cardiovascular Risk Factor inequalities
Heart (British Cardiac Society), 2006Co-Authors: Georgios Lyratzopoulos, Richard F Heller, Patrick Mcelduff, Margaret Hanily, Philip S. LewisAbstract:Objectives: To examine recent time trends in blood pressure (BP), total cholesterol, body mass index (BMI) and current smoking among people in the UK of different deprivation groups. Design: Repeatable survey. Setting: Primary care-based UK cardiovascular Risk Factor Screening programme (58 Stockport general practices). Participants: 37 161 women and 33 977 men aged 35–60 years responding to a Screening invitation and with a first Screening episode during 1989–99. Results: There were significant decreasing trends in total cholesterol (−0.06 mmol/l/year, 95% confidence interval (CI) −0.07 to −0.06 for women, −0.07 mmol/l/year, 95% CI −0.07 to −0.06 for men), with a significantly faster drop in more deprived groups (−0.005 mmol/year/increasing deprivation group, 95% CI −0.01 to −0.001 for both sexes). There were decreasing trends in current smoking prevalence (odds ratio (OR) 0.97/year, 95% CI 0.96 to 0.97 for women, OR 0.96/year, 95% CI 0.95 to 0.96 for men) with a significantly slower drop in the more deprived groups (OR 1.01/year/increasing deprivation group, 95% CI 1.00 to 1.01 for both sexes). There were significant increasing trends in BMI (0.11 kg/m 2 /year in women, 95% CI 0.09 to 0.13, 0.10 kg/m 2 /year in men, 95% CI 0.08 to 0.11), with a significantly slower increase in the more deprived groups among men only (−0.02 kg/m 2 /year/increasing deprivation group, 95% CI −0.01 to −0.03). Inequality in BP narrowed among men but widened among women. Conclusion: Inequalities in Risk Factors between different deprivation groups may be both widening (smoking, BP in women) and narrowing (total cholesterol, BMI and BP in men). Given baseline inequalities in Risk Factors levels, these trends suggest that inequalities in cardiovascular disease are likely to persist in the future.
Miriam Rabkin - One of the best experts on this subject based on the ideXlab platform.
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integrating cardiovascular disease Risk Factor Screening into hiv services in swaziland lessons from an implementation science study
AIDS, 2018Co-Authors: Miriam Rabkin, Anton Palma, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Harriet Nuwagababiribonwoha, Pido Bongomin, V Okello, Raymond Bitchong, Wafaa ElsadrAbstract:OBJECTIVE To study the feasibility of cardiovascular disease Risk Factor (CVDRF) Screening at an HIV clinic in Swaziland. METHODS A sample of HIV-positive patients at least 40 years on antiretroviral treatment was screened for hypertension, diabetes, hyperlipidemia, and tobacco smoking. RESULTS A total of 1826 patients were screened; 684 (39%) had at least one CVDRF. Screening volume varied markedly, and was limited by staffing, space, and supplies. DISCUSSION CVDRF Screening was feasible and prevalence of Risk Factors in people living with HIV at least 40 years was high.
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A time-motion study of cardiovascular disease Risk Factor Screening integrated into HIV clinic visits in Swaziland.
Journal of the International AIDS Society, 2018Co-Authors: Anton Palma, Miriam Rabkin, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Pido Bongomin, V Okello, Raymond Bitchong, Harriet Nuwagaba-biribonwoha, Wafaa El-sadrAbstract:INTRODUCTION Screening of modifiable cardiovascular disease (CVD) Risk Factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of Screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of Screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. METHODS A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without Screening and measured time spent on HIV and CVD Risk Factor Screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with Screening. RESULTS We observed 172 patient visits (122 with CVD Risk Factor Screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p
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a time motion study of cardiovascular disease Risk Factor Screening integrated into hiv clinic visits in swaziland
Journal of the International AIDS Society, 2018Co-Authors: Anton Palma, Miriam Rabkin, Samkelo Simelane, Averie B Gachuhi, Margaret L Mcnairy, Harriet Nuwagababiribonwoha, Pido Bongomin, V Okello, Raymond BitchongAbstract:INTRODUCTION Screening of modifiable cardiovascular disease (CVD) Risk Factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of Screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of Screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. METHODS A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without Screening and measured time spent on HIV and CVD Risk Factor Screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with Screening. RESULTS We observed 172 patient visits (122 with CVD Risk Factor Screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p < 0.01). Time spent on HIV care was not affected: 4 (2 to 10) versus 4 (2 to 11) (p = 0.57). We recruited 126 patients for exit interviews, all of whom indicated that they would recommend Screening to others. CONCLUSION Provision of CVD Risk Factor Screening more than tripled the length of routine HIV clinic visits but did not reduce the time spent on HIV services. Programme managers need to take longer visit duration into account in order to effectively integrate CVD Risk Factor Screening and counselling into HIV programmes.
