title: [The impact of nurse-led case management on the quality of HIV care].
abstract: BACKGROUND
  Monitoring the quality of human immunodeficiency virus (HIV) care and evaluating the effectiveness of HIV case management programs (CMPs) as approaches to raising the rate of HIV care retention and to improving the efficacy of viral suppression after the initiation of highly active antiretroviral therapy (HAART) are important focuses of research worldwide.
  
  
  OBJECTIVE
  This study describes the trends and evaluates the influence of CMPs on retention in care and viral suppression among patients in Taiwan diagnosed with HIV from 2008 to 2010.
  
  
  METHODS
  This retrospective study enrolled 1,302 HIV-positive individuals who had visited at least one outpatient clinic between 2008 and 2012. Of these patients, 715 (54.9%) were enrolled in an HIV CMP. Trend analysis and logistic regression were applied to investigate longitudinal trends and the impact of CMPs on the quality of HIV care.
  
  
  RESULTS
  Retention in care improved substantially from 44.5% in 2008 to 57.3% in 2012. The percentage of viral suppression within 12 months of the initiation of HAART increased from 88.4% in 2008 to 93.5% in 2012. Of the patients who were in HIV CMPs, 73.6% were retained in care, which was significantly higher than the 31.7% among those who were not enrolled in CMPs (p<.001). Among the patients who received HAART for more than 180 days, those who achieved viral suppression within 12 months were significantly more likely to be retained in care (adjusted odds ratio=5.36, 95% CI=2.6-10.9, p<.001).
  
  
  CONCLUSIONS
  Nurse-led case management programs play a role in improving HIV-related health outcomes. HIV CMPs are beneficial to HIV-infected patients by improving retention in care and are indirectly associated with successful viral suppression.
authors.affiliation: Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC.
authors.forename: Yen-Chin
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Department of Nursing, National Cheng Kung University Hospital, Taiwan, ROC.
authors.forename: Yi-Yin
authors.initials: YY
authors.lastname: Lai
authors.affiliation: Department of Nursing, National Cheng Kung University Hospital, Taiwan, ROC.
authors.forename: Hsiao-Ying
authors.initials: HY
authors.lastname: Liu
authors.affiliation: Department of Nursing, National Cheng Kung University Hospital, Taiwan, ROC.
authors.forename: Yun-Hui
authors.initials: YH
authors.lastname: Pai
authors.affiliation: Department of Infection, National Cheng Kung University Hospital, Taiwan, ROC.
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ko
authors.affiliation: Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC. nyko@mail.ncku.edu.tw.
authors.forename: Nai-Ying
authors.initials: NY
authors.lastname: Ko
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active; D019090:Case Management; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000451:nursing*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D012189:Retrospective Studies
keywords: HIV/AIDS; case management; retention in care; viral suppression