Authors (including presenting author) :
Chan SN(1), Chan S(1), Fong CY(1), Au SM(1), Chan KY(1), Yiu YH(1), Ng SK(1), Yeung KY(1), Kwong TS(1)(2), Wu TC(1)(2), Lee MP(1)
Affiliation :
1. HIV Clinical Service, Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR
2. Division of Infectious Diseases, Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR
Introduction :
HIV Integrated Nurse Clinic (IMSN) of Queen Elizabeth Hospital was first accredited in year 2009. Services were enhanced since year October 2019 with the objectives of: A/ Providing counselling and monitoring on treatment efficacy and adherence, so as to reduce workload of clinic doctors and allow spacing out doctor’s follow-up clinic interval in stable patients; B/ Sexual health counselling including sexually transmitted infections (STI) screening and treatment delivery; C/ Spouse / partner’s HIV screening, education and counselling; D/ Psychosocial assessment and early referral to be made for patients having psychosocial needs; and E/ Vaccination, health education and lifestyle modification.
Objectives :
To evaluate the performance and outcomes of QEH HIV IMSN.
Methodology :
Retrospective review is carried out for the period between January 2020 to December 2024 on: 1/ IMSN clinic attendance and the associated purpose; 2/ Loss to follow up at IMSN; 3/ Percentage of patient maintaining HIV viral suppression during IMSN follow up; 4/ Percentage of patients maintaining good drug adherence (i.e. visual analog scale >90 ); 5/ Patient satisfaction score, which was assessed by using the “Integrated Model of Specialist Outpatient service-HIV Nurse Clinic Client Satisfaction Survey”.
Result & Outcome :
A total of 643 patients were ever recruited to IMSN since 2019, among which 119 patients later withdrew from IMSN. Reasons for withdrawal included emigration in 34%, inability to attend IMSN in 40%, change in physical condition (e.g. medical illnesses other than HIV) in 18%, loss to follow-up or transferal to other treatment center in 8%. The yearly total number of clinic attendance were 1187, 2027, 2049, 2984, 3119 for year 2020 to 2024, among which 783 and 861 clinic attendances had STI screening and counselling done for the year 2023 and 2024 respectively. 98.3-99.7% of patients maintained viral suppression during IMSN follow-up, while 99-100% of patients maintained satisfactory treatment adherence as assessed by the Visual Analog Scale every year.
The average patient satisfaction score towards the services of IMSN was 3.79, 3.78, 3.82 out of a total score 4.0 for year 2022, 2023, 2024 respectively. In particular, patients found that IMSN strengthened their understanding of the illness and relevant treatment, they were also highly satisfied with the attitude of nurse, the overall environment of IMSN and the associated short waiting time.
The Integrated Nurse Clinic of QEH HIV Clinic offers a wide range of clinical services supplementing the management provided by doctors, with the objective of offering holistic care and management to patients. Patients receiving care at IMSN were highly satisfied with the services provided by IMSN.
