Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia

D. C. Boettiger; M. Glaw; J. Ross; B. V. Huy; B. S.L. Heng; R. Ditangco; S. Kiertiburanakul; A. Avihingsanon; D. Cuong; N. Kumarasamy; A. Kamarulzaman; P. S. Ly; E. Yunihastuti; T. Parwati Merati; F. Zhang; S. Khusuwan; R. Chaiwarith; M. P. Lee; S. Sangle; J. Y. Choi; W. W. Ku; J. Tanuma; O. T. Ng; A. H. Sohn; C. W. Wester; D. Nash; C. Mugglin; S. Pujari

doi:10.1016/s2055-6640(20)30005-4

Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia

D. C. Boettiger, M. Glaw, J. Ross, B. V. Huy, B. S.L. Heng, R. Ditangco, S. Kiertiburanakul, A. Avihingsanon, D. Cuong, N. Kumarasamy, A. Kamarulzaman, P. S. Ly, E. Yunihastuti, T. Parwati Merati, F. Zhang, S. Khusuwan, R. Chaiwarith, M. P. Lee, S. Sangle, J. Y. ChoiW. W. Ku, J. Tanuma, O. T. Ng, A. H. Sohn, C. W. Wester, D. Nash, C. Mugglin, S. Pujari

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Objectives: Integration of HIV and non-communicable disease services improves the quality and efficiency of care in low- A nd middle-income countries (LMICs). We aimed to describe current practices for the screening and management of atherosclerotic cardiovascular disease (ASCVD) among adult HIV clinics in Asia. Methods: Sixteen LMICsites included in the International Epidemiology Databases to Evaluate AIDS-Asia-Pacific network were surveyed. Results: Sites were mostly (81%) based in urban public referral hospitals. Half had protocols to assess tobacco and alcohol use. Protocols for assessing physical inactivity and obesity were in place at 31% and 38% of sites, respectively. Most sites provided educational material on ASCVD risk factors (between 56% and 75% depending on risk factors). Atotal of 94% reported performing routine screening for hypertension, 100% for hyperlipidaemia and 88% for diabetes. Routine ASCVD risk assessment was reported by 94% of sites. Protocols for the management of hypertension, hyperlipidaemia, diabetes, high ASCVD risk and chronic ischaemic stroke were in place at 50%, 69%, 56%, 19% and 38% of sites, respectively. Blood pressure monitoring was free for patients at 69% of sites; however, most required patients to pay some or all the costs for other ASCVD-related procedures. Medications available in the clinic or within the same facility included angiotensin-converting enzyme inhibitors (81%), statins (94%) and sulphonylureas (94%). Conclusion: The consistent availability of clinical screening, diagnostic testing and procedures and the availability of ASCVD medications in the Asian LMICclinics surveyed are strengths that should be leveraged to improve the implementation of cardiovascular care protocols.

Original language	English
Pages (from-to)	11-18
Number of pages	8
Journal	Journal of Virus Eradication
Volume	6
Issue number	1
DOIs	https://doi.org/10.1016/s2055-6640(20)30005-4
Publication status	Published - 2020

Bibliographical note

Funding Information:
DcB has received research funding from gilead sciences and is supported by a national health and Medical research council early career Fellowship (aPP1140503); Mgl has received unrestricted grants from Boehringer ingelhiem, gilead sciences, Merck sharp & Dohme, Bristol-Myers squibb, Janssen-cilag and ViiV healthcare, consultancy fees from gilead sciences, and data and safety monitoring board sitting fees from sirtex Pty ltd; ahs has received research funding and travel support from ViiV healthcare; OTn is supported by a national Medical research council clinician scientist award (MOh-000276). all other authors report no potential conflicts of interest.

Funding Information:
The international epidemiology Databases to evaluate aiDs (ieDea) is supported by the national institute of allergy and infectious Diseases (100000060), the eunice Kennedy shriver national institute of child health and human Development (100009633), the national institute on Drug abuse (100000026), the national cancer institute (100000054) and the national institute of Mental health (100000025) in accordance with the regulatory requirements of the national institutes of health under award numbers U01ai069911 (east africa), U01ai069919 (West africa), U01ai096299 (central africa), U01ai069924 (southern africa) and U01ai069907 (asia-Pacific). The Kirby institute (data centre for the ieDea asia-Pacific) is funded by the australian government Department of health and ageing (501100001027) and is affiliated with the Faculty of Medicine, University of new south Wales (sydney, australia). This work is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned.

Publisher Copyright:
© 2019 Mediscript Ltd. All rights reserved.

All Science Journal Classification (ASJC) codes

Epidemiology
Immunology
Public Health, Environmental and Occupational Health
Infectious Diseases
Virology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/s2055-6640(20)30005-4

Cite this

Boettiger, D. C., Glaw, M., Ross, J., Huy, B. V., Heng, B. S. L., Ditangco, R., Kiertiburanakul, S., Avihingsanon, A., Cuong, D., Kumarasamy, N., Kamarulzaman, A., Ly, P. S., Yunihastuti, E., Merati, T. P., Zhang, F., Khusuwan, S., Chaiwarith, R., Lee, M. P., Sangle, S., ... Pujari, S. (2020). Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia. Journal of Virus Eradication, 6(1), 11-18. https://doi.org/10.1016/s2055-6640(20)30005-4

@article{b35deaf524914d67bc5d2bd9540be4c9,

title = "Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia",

abstract = "Objectives: Integration of HIV and non-communicable disease services improves the quality and efficiency of care in low- A nd middle-income countries (LMICs). We aimed to describe current practices for the screening and management of atherosclerotic cardiovascular disease (ASCVD) among adult HIV clinics in Asia. Methods: Sixteen LMICsites included in the International Epidemiology Databases to Evaluate AIDS-Asia-Pacific network were surveyed. Results: Sites were mostly (81%) based in urban public referral hospitals. Half had protocols to assess tobacco and alcohol use. Protocols for assessing physical inactivity and obesity were in place at 31% and 38% of sites, respectively. Most sites provided educational material on ASCVD risk factors (between 56% and 75% depending on risk factors). Atotal of 94% reported performing routine screening for hypertension, 100% for hyperlipidaemia and 88% for diabetes. Routine ASCVD risk assessment was reported by 94% of sites. Protocols for the management of hypertension, hyperlipidaemia, diabetes, high ASCVD risk and chronic ischaemic stroke were in place at 50%, 69%, 56%, 19% and 38% of sites, respectively. Blood pressure monitoring was free for patients at 69% of sites; however, most required patients to pay some or all the costs for other ASCVD-related procedures. Medications available in the clinic or within the same facility included angiotensin-converting enzyme inhibitors (81%), statins (94%) and sulphonylureas (94%). Conclusion: The consistent availability of clinical screening, diagnostic testing and procedures and the availability of ASCVD medications in the Asian LMICclinics surveyed are strengths that should be leveraged to improve the implementation of cardiovascular care protocols.",

author = "Boettiger, {D. C.} and M. Glaw and J. Ross and Huy, {B. V.} and Heng, {B. S.L.} and R. Ditangco and S. Kiertiburanakul and A. Avihingsanon and D. Cuong and N. Kumarasamy and A. Kamarulzaman and Ly, {P. S.} and E. Yunihastuti and Merati, {T. Parwati} and F. Zhang and S. Khusuwan and R. Chaiwarith and Lee, {M. P.} and S. Sangle and Choi, {J. Y.} and Ku, {W. W.} and J. Tanuma and Ng, {O. T.} and Sohn, {A. H.} and Wester, {C. W.} and D. Nash and C. Mugglin and S. Pujari",

note = "Funding Information: DcB has received research funding from gilead sciences and is supported by a national health and Medical research council early career Fellowship (aPP1140503); Mgl has received unrestricted grants from Boehringer ingelhiem, gilead sciences, Merck sharp & Dohme, Bristol-Myers squibb, Janssen-cilag and ViiV healthcare, consultancy fees from gilead sciences, and data and safety monitoring board sitting fees from sirtex Pty ltd; ahs has received research funding and travel support from ViiV healthcare; OTn is supported by a national Medical research council clinician scientist award (MOh-000276). all other authors report no potential conflicts of interest. Funding Information: The international epidemiology Databases to evaluate aiDs (ieDea) is supported by the national institute of allergy and infectious Diseases (100000060), the eunice Kennedy shriver national institute of child health and human Development (100009633), the national institute on Drug abuse (100000026), the national cancer institute (100000054) and the national institute of Mental health (100000025) in accordance with the regulatory requirements of the national institutes of health under award numbers U01ai069911 (east africa), U01ai069919 (West africa), U01ai096299 (central africa), U01ai069924 (southern africa) and U01ai069907 (asia-Pacific). The Kirby institute (data centre for the ieDea asia-Pacific) is funded by the australian government Department of health and ageing (501100001027) and is affiliated with the Faculty of Medicine, University of new south Wales (sydney, australia). This work is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned. Publisher Copyright: {\textcopyright} 2019 Mediscript Ltd. All rights reserved.",

year = "2020",

doi = "10.1016/s2055-6640(20)30005-4",

language = "English",

volume = "6",

pages = "11--18",

journal = "Journal of Virus Eradication",

issn = "2055-6640",

publisher = "Mediscript Ltd",

number = "1",

}

Boettiger, DC, Glaw, M, Ross, J, Huy, BV, Heng, BSL, Ditangco, R, Kiertiburanakul, S, Avihingsanon, A, Cuong, D, Kumarasamy, N, Kamarulzaman, A, Ly, PS, Yunihastuti, E, Merati, TP, Zhang, F, Khusuwan, S, Chaiwarith, R, Lee, MP, Sangle, S, Choi, JY, Ku, WW, Tanuma, J, Ng, OT, Sohn, AH, Wester, CW, Nash, D, Mugglin, C & Pujari, S 2020, 'Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia', Journal of Virus Eradication, vol. 6, no. 1, pp. 11-18. https://doi.org/10.1016/s2055-6640(20)30005-4

TY - JOUR

T1 - Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia

AU - Boettiger, D. C.

AU - Glaw, M.

AU - Ross, J.

AU - Huy, B. V.

AU - Heng, B. S.L.

AU - Ditangco, R.

AU - Kiertiburanakul, S.

AU - Avihingsanon, A.

AU - Cuong, D.

AU - Kumarasamy, N.

AU - Kamarulzaman, A.

AU - Ly, P. S.

AU - Yunihastuti, E.

AU - Merati, T. Parwati

AU - Zhang, F.

AU - Khusuwan, S.

AU - Chaiwarith, R.

AU - Lee, M. P.

AU - Sangle, S.

AU - Choi, J. Y.

AU - Ku, W. W.

AU - Tanuma, J.

AU - Ng, O. T.

AU - Sohn, A. H.

AU - Wester, C. W.

AU - Nash, D.

AU - Mugglin, C.

AU - Pujari, S.

N1 - Funding Information: DcB has received research funding from gilead sciences and is supported by a national health and Medical research council early career Fellowship (aPP1140503); Mgl has received unrestricted grants from Boehringer ingelhiem, gilead sciences, Merck sharp & Dohme, Bristol-Myers squibb, Janssen-cilag and ViiV healthcare, consultancy fees from gilead sciences, and data and safety monitoring board sitting fees from sirtex Pty ltd; ahs has received research funding and travel support from ViiV healthcare; OTn is supported by a national Medical research council clinician scientist award (MOh-000276). all other authors report no potential conflicts of interest. Funding Information: The international epidemiology Databases to evaluate aiDs (ieDea) is supported by the national institute of allergy and infectious Diseases (100000060), the eunice Kennedy shriver national institute of child health and human Development (100009633), the national institute on Drug abuse (100000026), the national cancer institute (100000054) and the national institute of Mental health (100000025) in accordance with the regulatory requirements of the national institutes of health under award numbers U01ai069911 (east africa), U01ai069919 (West africa), U01ai096299 (central africa), U01ai069924 (southern africa) and U01ai069907 (asia-Pacific). The Kirby institute (data centre for the ieDea asia-Pacific) is funded by the australian government Department of health and ageing (501100001027) and is affiliated with the Faculty of Medicine, University of new south Wales (sydney, australia). This work is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned. Publisher Copyright: © 2019 Mediscript Ltd. All rights reserved.

PY - 2020

Y1 - 2020

N2 - Objectives: Integration of HIV and non-communicable disease services improves the quality and efficiency of care in low- A nd middle-income countries (LMICs). We aimed to describe current practices for the screening and management of atherosclerotic cardiovascular disease (ASCVD) among adult HIV clinics in Asia. Methods: Sixteen LMICsites included in the International Epidemiology Databases to Evaluate AIDS-Asia-Pacific network were surveyed. Results: Sites were mostly (81%) based in urban public referral hospitals. Half had protocols to assess tobacco and alcohol use. Protocols for assessing physical inactivity and obesity were in place at 31% and 38% of sites, respectively. Most sites provided educational material on ASCVD risk factors (between 56% and 75% depending on risk factors). Atotal of 94% reported performing routine screening for hypertension, 100% for hyperlipidaemia and 88% for diabetes. Routine ASCVD risk assessment was reported by 94% of sites. Protocols for the management of hypertension, hyperlipidaemia, diabetes, high ASCVD risk and chronic ischaemic stroke were in place at 50%, 69%, 56%, 19% and 38% of sites, respectively. Blood pressure monitoring was free for patients at 69% of sites; however, most required patients to pay some or all the costs for other ASCVD-related procedures. Medications available in the clinic or within the same facility included angiotensin-converting enzyme inhibitors (81%), statins (94%) and sulphonylureas (94%). Conclusion: The consistent availability of clinical screening, diagnostic testing and procedures and the availability of ASCVD medications in the Asian LMICclinics surveyed are strengths that should be leveraged to improve the implementation of cardiovascular care protocols.

AB - Objectives: Integration of HIV and non-communicable disease services improves the quality and efficiency of care in low- A nd middle-income countries (LMICs). We aimed to describe current practices for the screening and management of atherosclerotic cardiovascular disease (ASCVD) among adult HIV clinics in Asia. Methods: Sixteen LMICsites included in the International Epidemiology Databases to Evaluate AIDS-Asia-Pacific network were surveyed. Results: Sites were mostly (81%) based in urban public referral hospitals. Half had protocols to assess tobacco and alcohol use. Protocols for assessing physical inactivity and obesity were in place at 31% and 38% of sites, respectively. Most sites provided educational material on ASCVD risk factors (between 56% and 75% depending on risk factors). Atotal of 94% reported performing routine screening for hypertension, 100% for hyperlipidaemia and 88% for diabetes. Routine ASCVD risk assessment was reported by 94% of sites. Protocols for the management of hypertension, hyperlipidaemia, diabetes, high ASCVD risk and chronic ischaemic stroke were in place at 50%, 69%, 56%, 19% and 38% of sites, respectively. Blood pressure monitoring was free for patients at 69% of sites; however, most required patients to pay some or all the costs for other ASCVD-related procedures. Medications available in the clinic or within the same facility included angiotensin-converting enzyme inhibitors (81%), statins (94%) and sulphonylureas (94%). Conclusion: The consistent availability of clinical screening, diagnostic testing and procedures and the availability of ASCVD medications in the Asian LMICclinics surveyed are strengths that should be leveraged to improve the implementation of cardiovascular care protocols.

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DO - 10.1016/s2055-6640(20)30005-4

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VL - 6

SP - 11

EP - 18

JO - Journal of Virus Eradication

JF - Journal of Virus Eradication

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ER -

Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia

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Bibliographical note

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UN SDGs

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