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Press release: UK-CAB survey report on HIV drug prescribing at London clinics

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Press release: UK-CAB survey report on HIV drug prescribing at London clinics
Posted on: July 5 2012, 05:56 pm
Last edit: July 10 2012, 12:09 pm

PRESS RELEASE
FOR IMMEDIATE RELEASE                     6 JULY 2012

How patients feel about drug prescribing changes in London

The UK-CAB is a community advocacy organisation focused on HIV-related treatment issues. [1]

HIV clinics in London have worked together to buy HIV medication and the government froze budgets across the NHS in April 2011. This meant all services had to find savings equivalent to 4% of their annual budget. For the HIV services in London this meant finding savings of 8-10 million over two years. [3]

From November 2011 to June 2012, the UK-CAB organised an online community survey relating to changing treatment that had been introduced in April 2011. The survey was publicised on community websites and HIV press. This included i-Base, NAM and THT and Baseline magazine. [2, 3]

The survey wanted to know whether the guidelines were:
i)   generally safe and effective
ii)   not resulting in reduced care
iii)   being interpreted correctly in clinics

The survey was partly an additional safety measure so that anyone who was unhappy about their care could have a way to report this. It also wanted to understand how people had experienced these changes.

There are nearly 30,000 HIV positive people in London, 83% are on treatment. Of the 260 respondents to the survey, only 226 responses fitted the criteria and could therefore be analysed. Of these, 74 people who had been involved in a discussion about changing treatment, 22 actively asked to change treatment, and 50 were asked by their clinic to change. Two people had their meds changed without being involved in a discussion these were examples of care that was clearly inappropriate.

From the survey, we conclude that:

i.   It is reassuring that it did not find widespread problems as a result of new London guidelines, although it did show some issues of poor care.
ii.   The outcomes of people who changed treatment was far more likely to cause no noticeable difference or actually improve care than have a negative result.
iii.   The CAB survey is one of the few documents to report the outcomes of the changes to London prescribing.
iv.   The Commissioners and some clinics have been working towards an audit of the outcomes, this process has been slow and protracted and it is not acceptable that these results have still not been presented.
v.   Poor communication however was a significant issue for many people and patient choice, again for many people, is seen as central to any decision about treatment and care.
vi.   Further change is likely to continue to directly affect the way HIV drugs are prescribed. It is imperative that HIV positive people and their advocates  are involved in all aspects of our care. This will particularly affect the introduction of generic ARVs and access to new drugs.

A detailed report is available on the UK-CAB website.[7]

ENDS
------------
For editors:

1.   UK-CAB is a national network of HIV treatment advocates
http://www.ukcab.net

2.   CAB survey for people getting HIV care at London clinics
http://www.surveymonkey.com/s/UKCABLondonTreatmentSurvey

3.   The London Consortium Drug Group included lead clinicians from London clinics, HIV-specialist pharmacists, community advocates, HIV-positive people and health commissioners. Document from the group will be posted online. http://www.londonspecialisedcommissioning.nhs.uk/

4.   A slide set summary of the recommendations in PDF and the PowerPoint files are available in PDF format:
http://www.londonspecialisedcommissioning.nhs.uk/documents/371.pdf

5.   See also: London HIV Consortium issues new guidelines for ARV prescribing.
http://i-base.info/htb/14803

6.   Marshall N et al. Switching to atazanavir due to therapeutic tenders: short term outcomes. 18th BHIVA Conference, 18-20 April 2012, Birmingham. Poster abstract P195. Reported in HTB:
http://i-base.info/htb/16527

7.   UK-CAB Survey report: HIV prescribing at London clinics July 2012
http://www.ukcab.net

Contact: UKCAB, 4th floor , 57 Great Suffolk Street, London SE1 0BB, Tel: 020 7407 8488 
Fax: 020 7407 8499 Email: ukcab@ukcab.net




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