Integrated health services can enhance patient care, reduce costs : Study

Washington DC [US], October 6 (ANI): According to a recent study, integrated health care for chronic high-burden disorders is feasible and health services might provide high-quality services for less money than with the existing model of separate vertical care for each condition.
When compared to services for HIV, health care for non-communicable disorders including diabetes and hypertension is now dispersed and of unequal quality. Around 2 million premature deaths are ascribed each year to the effects of diabetes and hypertension, and much less than half of those who begin treatment on the continent remain in care one year later.
In contrast, the vast majority of HIV-positive individuals are receiving routine care and have their viral load reduced. HIV-related mortality rates have decreased more than five times since their peak in the early 2000s.
In order to enhance outcomes for persons with non-communicable diseases, there has been an increasing interest in establishing one-stop integrated service delivery clinics using the platforms created for and the knowledge obtained by HIV programmes. However, there was a lack of high-quality research on the viability of such clinics, their potential impact on HIV outcomes, and their costs.
This evidence gap is addressed in the research, which was published in The Lancet. It presents findings from a sizable study that was coordinated by the National Institute for Medical Research in Tanzania, the MRC/UVRI/LSHTM Uganda Research Unit, and first by LSTM and then by the UCL Institute for Global Health.
Numerous institutions from Tanzania, Uganda, and Europe participated in the study. It demonstrated that integrated care was related with high levels of patient adherence to treatment for those with diabetes or hypertension, that it had no negative effects on the rate of viral suppression in HIV-positive individuals, and that it was cost-effective for healthcare organisations.
In 2021, the World Health Organisation suggested combining HIV services with those for diabetes and hypertension, although there was no information available at the time on the results. This study backs up the WHO's suggestion, which also called for greater information on costs, preferences, and health outcomes.
Dr Meg Doherty, Director of the World Health Organisation Department of Global HIV, Hepatitis and STI Programmes, said, "This was a large, ambitious and well-conducted study with the potential to change policy and practice. It is the first study to test successfully the concept of a fully integrated one-stop clinic for people with HIV or non-communicable conditions, with excellent HIV and NCD outcomes. It is exciting to see that by including hypertension and diabetes screening in the HIV clinic in these two countries, there was no change in HIV viral load suppression outcomes."
Dr Gerald Mutungi, Assistant Commissioner for Non-Communicable Diseases in Uganda, said, "This study is the culmination of more than six years of research, conducted in partnership with the Ministries of Health. It demonstrates that integrated management is effective and cost-saving. The findings will inform future control of non-communicable diseases on the continent."
Professor Tumaini Nagu, Chief Medical Officer of Tanzania, said, "Our study provides clear evidence for policymakers to consider scale up of integrated care for HIV, diabetes and hypertension. With the high burden of non-communicable conditions now in Africa, and more and more people living with multiple chronic conditions, integrated management will be an essential and cost-effective approach for the continent."
Stephen Watiti, a patient representative based in Uganda and an author on the study, said, "Patients are interested in their overall health and do not look at diseases individually. Integrated management will be a big welcome going forward, thanks to the findings of this study".
Katie Dain, CEO of the NCD Alliance, said, "We need the same powerful and coordinated global response to tackle NCDs that we've seen for HIV. We know how to do this, and this time, we can build on existing infrastructure. Integrated care is a win-win opportunity to make NCD care more accessible for people living with HIV and cost-effectively strengthen our health systems."
Professor Shabbar Jaffar (UCL Institute for Global Health), the corresponding author, said, "I am very proud of all of the investigators. We worked as equal partners and because of this were able to pull off this most challenging of research studies." (ANI)