What Contents Should Be Implemented When An HIV Patient Is Re-examined?
Article 6 of Circular 28/2018/TT-BYT, which prescribes the management of HIV-infected individuals and those exposed to HIV at medical facilities, issued by the Minister of Health and effective from January 1, 2019, prescribes the implementation for HIV-infected individuals returning for examination as follows:
Conduct medical examinations and monitor clinical response, immunology, virology, treatment adherence, diagnose concurrent diseases, and manage according to the Guidelines on HIV/AIDS Treatment and Care.
Prescribing and dispensing anti-HIV drugs:
a) For patients treated with anti-HIV drugs for less than 12 months, prescribe and dispense drugs in quantities not exceeding 30 days of use. If the patient wishes to receive anti-HIV drugs at the commune-level health station, assess eligibility to receive drugs at the commune-level health station, prescribe, dispense, and instruct the HIV-infected individual on how to receive drugs at the commune health station according to the provisions at Point c, Point d, Clause 2 of this Article. Issue a referral document according to the instructions in Appendix 02 issued with this Circular. Schedule a follow-up examination according to provisions in Clause 3 of this Article;
b) For patients treated with anti-HIV drugs for 12 months or more:
If the anti-HIV drug treatment is not stable: prescribe and dispense anti-HIV drugs in quantities not exceeding 30 days of use.
If the anti-HIV drug treatment is stable and there is a need to continue receiving drugs at the treatment facility: prescribe and dispense anti-HIV drugs in quantities not exceeding 90 days of use.
If the patient is on stable anti-HIV drug treatment and wishes to receive drugs at the commune-level health station: Prescribe and dispense drugs and instruct the HIV-infected individual on how to receive drugs at the commune health station according to the provisions at Point c, Point d, Clause 2 of this Article. Issue a referral document according to the instructions in Appendix 02 issued with this Circular.
c) Eligibility criteria for patients receiving anti-HIV drugs at the commune health station: HIV-infected individuals who have been on anti-HIV drug treatment for at least 6 months, showing good clinical, immunological response, good treatment adherence, no side effects requiring regular monitoring, no concurrent diseases, and wishing to receive drugs at the commune health station;
d) Prescribing and dispensing drugs for patients receiving anti-HIV drugs at the commune health station: The treatment facility prescribes anti-HIV drugs in the outpatient medical record and the patient's medical examination book with quantities not exceeding 90 days of use. The prescribed drugs can be dispensed in up to 3 sessions. Each session's maximum drug quantity is for 30 days of use. In the first session, the patient receives drugs at the treatment facility. In subsequent sessions, the patient receives drugs at the commune health station. When the drug supply at the commune health station is depleted or according to the scheduled follow-up examination, the patient returns to the treatment facility for further examination and prescription.
- Follow-up examination:
a) For patients receiving anti-HIV drugs at the treatment facility: Schedule a follow-up examination when the supplied drugs are depleted or if there are abnormal signs, noting the follow-up examination schedule in the patient's medical examination book;
b) For patients receiving anti-HIV drugs at the commune health station: Conduct regular follow-up examinations every 3 months at the treatment facility or when there are abnormal signs, noting the follow-up examination schedule in the patient's medical examination book.
If a patient arrives for examination and medication dispensing earlier than the scheduled appointment, the patient will still receive medical examination and medication, and the quantity of drugs dispensed during this treatment session will be accumulated with the quantity of drugs not yet used until this examination and sufficient for use until the next scheduled follow-up.
If a patient does not attend the follow-up examination at the scheduled time: The treatment facility will contact the patient or the family to remind the patient to return for a follow-up examination and medication according to the appointment schedule.
If a patient who has discontinued treatment returns for treatment: Based on the condition of the HIV-infected patient, the treatment facility will examine and treat the HIV-infected patient according to the provisions of Article 5 or Article 6 of this Circular.
The above represents the counseling content.
Respectfully!
