WHO SMART Guidelines - HIV
0.3.0 - ci-build

WHO SMART Guidelines - HIV - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

PlanDefinition: PlanDefinition - Care and treatment clinical visit (Experimental)

Official URL: http://smart.who.int/hiv/PlanDefinition/CareAndTreatmentClinicalVisit-PlanDefinition Version: 0.3.0
Active as of 2024-11-07 Computable Name: PlanDefinition_Care and treatment clinical visit

To initiate ART and to provide HIV care, treatment and integrated health services

Generated Narrative: PlanDefinition CareAndTreatmentClinicalVisit-PlanDefinition

url: PlanDefinition PlanDefinition - Care and treatment clinical visit

version: 0.3.0

name: PlanDefinition_Care and treatment clinical visit

title: PlanDefinition - Care and treatment clinical visit

type: Workflow Definition

status: Active

experimental: true

date: 2024-11-07 21:07:17+0000

publisher: WHO

contact: WHO: http://who.int

description:

To initiate ART and to provide HIV care, treatment and integrated health services

action

title: Care and treatment clinical visit business process

description: To initiate ART and to provide HIV care, treatment and integrated health services

participant

type: Patient

role: client

participant

type: Practitioner

role: TrainedLayProvider

action

id

HIV.D.1

title: Determine reason for visit

description: Search for client details in the system and determine reason for visit

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.2

title: Take vital signs

description: Also record weight, height, etc. For children, weight will be needed to determine dosage and to check for malnutrition.

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.3

title: Check for signs of serious illness

description: Any person who has signs of seriously illness should be referred to the appropriate higher-lever facility for management

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.4

title: Screen for TB

description: Adults and adolescents living with HIV should be screened for TB according to a clinical algorithm

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.5

title: Seriously ill?

description: Any person who has signs of serious illness should be referred to the appropriate higher-lever facility for management or receive emergency care, depending on availability and policies.

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.8

title: Capture or update client history

description: Discuss history with client and review available records. History-taking should include partner’s HIV status and whether the partner is virally suppressed on ART

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.9

title: First time initiating treatment?

description: This step checks whether the client is naïve to ART

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.10

title: Counsel returning clients

description: Adherence, such as whether client is picking up meds and/or has any barriers to adherence to their treatment(s), if so, set plan for adherence support

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.11

title: Retest for HIV using testing algorithm

description: WHO recommends that all programmes retest people diagnosed with HIV prior to initiating lifelong ART

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.12

title: Determine recommended screenings and tests

description: HIV.D12.DT Determine recommended screenings and tests

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.13

title: Examine client

description: Examine the client clinically, with a physical exam

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.14

title: Prevent, screen and manage comorbidities and coinfections

description: With ART, HIV is a chronic disease requiring lifetime care. WHO guidelines cover information on common and important concomitant conditions among people living with HIV, including: co-trimoxazole prophylaxis; the diagnosis, prevention and treatment of TB, viral hepatitis, malaria, sexually transmitted infections, cervical cancer prevention, nutrition, vaccinations, mental health and substance use

Participants

-TypeRole
*Patientclient

action

id

HIV.D.15

title: Determine clinical stage of HIV

description: HIV.D15.DT Determine WHO clinical stage of HIV

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.16

title: Perform other screenings

description: Conduct screenings based on recommendations and priorities and depending on the diagnostics that are available.

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.17

title: Check for signs of treatment failure

description: Review new diagnostic results

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.20

title: Diagnostics

description: Viral load should be tested routinely for early warning of virological failure and monitored if clinical or virological failure are suspected

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.21

title: Determine regimen and treatment options

description: For continuing care, check the dosage and need for readjustment or whether treatment failure is suspected.

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.22

title: Make informed decision on treatment

description: Even if client is eligible to start ART, the choice to accept or decline ART ultimately lies with the person or his or her caregiver, and if the decision is to defer initiation, ART can be offered again at subsequent visits

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.23

title: Prescribe

description: The scripting period should cover the period until the next clinical consultation (not until the following ART refill visit).

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.24

title: Counsel

description: Counsel clients on adherence.

Participants

-TypeRole
*PractitionerTrainedLayProvider

action

id

HIV.D.30

title: Laboratory diagnostics needed

description: Additional testing or specimen collection may be needed and may happen after the visit

Participants

-TypeRole
*PractitionerTrainedLayProvider