Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia
|J Ross et al.|
Objectives: Integration of HI V and non-communicable disease services improves the quality and efficiency of care in low- and middle-income countries (LMIC s). We aimed to describe current practices for the screening and management of atherosclerotic cardiovascular disease (ASCascVD) among adult HI V clinics in Asia.
Methods: Sixteen LMIC sites included in the International Epidemiology Databases to Evaluate AI DS – Asia-Pacific network were surveyed.
Results: S sites were mostly (81%) based in urban public referral hospitals. Half had protocols to assess tobacco and alcohol use. Protocols for assessing physical inactivity and obesity were in place at 31% and 38% of sites, respectively. Most sites provided educational material on ASCascVD risk factors (between 56% and 75% depending on risk factors). A total of 94% reported performing routine screening for hypertension, 100% for hyperlipidaemia and 88% for diabetes. Routine ASCascVD risk assessment was reported by 94% of sites. Protocols for the management of hypertension, hyperlipidaemia, diabetes, high ASCascVD risk and chronic ischaemic stroke were in place at 50%, 69%, 56%, 19% and 38% of sites, respectively. Blood pressure monitoring was free for patients at 69% of sites; however, most required patients to pay some or all the costs for other ASCascVD-related procedures. Medications available in the clinic or within the same facility included angiotensin-converting enzyme inhibitors (81%), statins (94%) and sulphonylureas (94%).
Conclusion: The consistent availability of clinical screening, diagnostic testing and procedures and the availability of ASCascVD medications in the Asian clinics surveyed are strengths that should be leveraged to improve the implementation of cardiovascular care protocols.