HealtH Matters 43
rEPOrt
particularly in A&E in Ireland would also
help to achieve earlier diagnosis. a survey
“looking to the future,
how to Maintain a
of 100 recently-HIV-diagnosed clients
tablet regiMen:
attending Beaumont found that 66 per
cent had presented to a healthcare setting,
there is a widely held
• link tablet taking to a habitual daily
such as an emergency Department or GP,
view amongst infection
activity; take the tablet first.
within the past two years with a range of • always do things in sequence.
symptoms consistent with HIV. Had these
specialists that, subject
ever get emails supposed to have
been screened at the time diagnosis might
to the availability of the
an attachment but find it is missing?
well have been made that much sooner. avoid doing that yourself by creating
In the early days of treating HIV, patients
necessary resources,
the attachment before you type the
often found it difficult to adhere to the word attachment in the email. In just
necessarily strict regimen of tablets
increased HIv screening
the same way, create a sequence
which involved a multiplicity of drugs
would prove highly cost
of events which begins with taking
several times a day. since then, however, tablets, for example, at the start of
development of a once-a-day fixed dose
effective.”
making breakfast each morning.
combination tablet has revolutionised • Keep spare pills with you at all times
treatment and made it easier to take and in convenient locations – a wallet
for patients. However, the virus is well or purse, the glovebox of the car – so
able to mutate if this Haart regime necessary resources, increased HIV if your plans change you still have
is not followed consistently and will screening would prove highly cost tablets to hand no matter where you
develop lifetime resistance to it. In the effective. find yourself.
specialist clinics, multi-disciplinary staff – a study undertaken in British Columbia • Use the alarm on your watch or
pharmacists, nurses, social workers, also found that every additional dollar spent on phone to remind you when it is time to
the secretary and doctors – teach clients early diagnosis and treatment saved $2 take the next tablet.
tools and tricks to help them to meet the on the higher levels of care required as a • take extra care during unusual times;
demanding adherence necessary before result of later diagnosis. so screening and weekends, holidays, funerals, etc.
treatment begins. HIV treatment are cost saving in the long • ask a friend to remind you daily.
at Beaumont, we have adopted a run. the cost of screening kits is only a • learn and practice for a month with
holistic approach, with social workers few euros each, against the cost of Haart vitamin tablets, so errors don’t matter.
looking at such issues as accommodation, therapy for HIV positive patients, which is • Fix other issues first before starting,
for example, while pharmacists and nurses approximately c10,000 per patient each e.g. homelessness, depression,
help to educate clients on how to maintain year for their entire lifetime. domestic security, disclosure, IV drug
therapy regimes. Many clients, particularly education of at risk groups, especially use, alcohol, chaotic lifestyle.
asylum seekers, have experienced serious heterosexuals, on the perils of engaging • Fill a pill box once a week, so you
traumas and need psychiatric support. in sex without using condoms, is also know for sure which day’s tablets you
some 70 per cent of asylum seekers have vitally important in any effort to contain have taken.
post-traumatic stress symptoms and 40 the spread of this infection. While some • When a missed dose occurs
per cent have depression. each of the useful steps are proposed under new interrogate yourself, like an air
members of the multidisciplinary team Department of education and science accident investigator, to see what went
is committed to a quality management guidelines on a social, personal and wrong and how to prevent it next time.
system, which we are developing, with health education, these tend to be non- • good strong relationships with
external help, in 2010. prescriptive and are, in any event, providers of care help.
According to the Euro HIV Index 2009, a voluntary component.
published last October, Ireland ranks 10th
of 29 countries in terms of the care of
and conditions provided for people living Professor McConkey leads the Infectious
with HIV/AIDS in Ireland. Index Director Dr Disease and Tropical Medicine services at
Beatriz Cebolla has noted that although Beaumont Hospital and is Head of the
Ireland performed consistently across all Department of International Health &
the measures comprising the index, there Tropical Medicine at the Royal College of
was room for improvement in all of them. Surgeons. He is a founding member of the
looking to the future, there is a widely Infectious Disease Society of Ireland and a
held view amongst infection specialists board member of AIDS Care Education
that, subject to the availability of the and Training Ireland.
HM Iss6.1 p1-70.indd 43 12/03/2010 15:15:52
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