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
| Official URL: http://smart.who.int/hiv/PlanDefinition/CareAndTreatmentClinicalVisit-PlanDefinition | Version: 0.3.0 | |||
| Active as of 2024-10-30 | 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: 2024-10-30 19:04:31+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.1title: Determine reason for visit
description: Search for client details in the system and determine reason for visit
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.2title: Take vital signs
description: Also record weight, height, etc. For children, weight will be needed to determine dosage and to check for malnutrition.
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.3title: 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
Type Role Practitioner TrainedLayProvider action
id
HIV.D.4title: Screen for TB
description: Adults and adolescents living with HIV should be screened for TB according to a clinical algorithm
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.5title: 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
Type Role Practitioner TrainedLayProvider action
id
HIV.D.8title: 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
Type Role Practitioner TrainedLayProvider action
id
HIV.D.9title: First time initiating treatment?
description: This step checks whether the client is naïve to ART
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.10title: 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
Type Role Practitioner TrainedLayProvider action
id
HIV.D.11title: Retest for HIV using testing algorithm
description: WHO recommends that all programmes retest people diagnosed with HIV prior to initiating lifelong ART
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.12title: Determine recommended screenings and tests
description: HIV.D12.DT Determine recommended screenings and tests
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.13title: Examine client
description: Examine the client clinically, with a physical exam
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.14title: 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
Type Role Patient client action
id
HIV.D.15title: Determine clinical stage of HIV
description: HIV.D15.DT Determine WHO clinical stage of HIV
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.16title: Perform other screenings
description: Conduct screenings based on recommendations and priorities and depending on the diagnostics that are available.
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.17title: Check for signs of treatment failure
description: Review new diagnostic results
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.20title: Diagnostics
description: Viral load should be tested routinely for early warning of virological failure and monitored if clinical or virological failure are suspected
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.21title: Determine regimen and treatment options
description: For continuing care, check the dosage and need for readjustment or whether treatment failure is suspected.
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.22title: 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
Type Role Practitioner TrainedLayProvider action
id
HIV.D.23title: Prescribe
description: The scripting period should cover the period until the next clinical consultation (not until the following ART refill visit).
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.24title: Counsel
description: Counsel clients on adherence.
Participants
Type Role Practitioner TrainedLayProvider action
id
HIV.D.30title: Laboratory diagnostics needed
description: Additional testing or specimen collection may be needed and may happen after the visit
Participants
Type Role Practitioner TrainedLayProvider