This study reinforces the need for the provision of integrated clinical care programmes linking therapeutic feeding and CTC programmes with HIV treatment programmes.
Beside having relevant clinical components, care programmes should therefore be seen as multidisciplinary protocols that encompass tasks, decision criteria and work procedures for the care professionals involved in the care trajectory of a specific patient category [ 31].
This is a concern both for individual clinical care and for programme evaluation, as unstructured interruption of treatment can lead to the development of drug resistance, [6] and there is uncertainty as to whether resources should be invested in defaulter tracing.
According to government officials, HEWs assume a coordinating role by referring patients to both health facilities for clinical care and to CHBC programmes for non-clinical care, and a supervisory role by educating family primary caregivers on how to provide home-based care for patients with HIV.
The ASN will discharge to usual clinical care all control group patients, and plan a programme of EBI for treatment group patients.
The reasons underlying this were that, in most large clinics nurses would be allocated to one programme and be responsible for clinical care, reports and monthly statistics.
After this, data sets become increasingly incomplete as patients left the programme and returned to usual clinical care.
At the time of the study, all health workers were active participants in their site's HIV treatment programme as members of the clinical care team.
The Southern African Treatment and Resistance Network SATuRNN) has developed models for implementation of antiretroviral drug resistance testing within HIV programmes, with the aim of integrating clinical care, training, surveillance and research [ 9, 10].
To quantify the impact of a practical, hospital-based nurse-coordinated prevention programme on cardiovascular risk, integrated into the routine clinical care of patients discharged after an acute coronary syndrome, as compared with usual care only.
