Did Universal Access to ARVT in Mexico Impact Suboptimal Antiretroviral Prescriptions?

Background. Universal access to antiretroviral therapy (ARVT) started in Mexico in 2001; no evaluation of the features of ARVT prescriptions over time has been conducted. The aim of the study is to document trends in the quality of ARVT-prescription before and after universal access. Methods. We des...

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Main Authors: Yanink Caro-Vega, Patricia Volkow, Juan Sierra-Madero, M. Arantxa Colchero, Brenda Crabtree-Ramírez, Sergio Bautista-Arredondo
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:AIDS Research and Treatment
Online Access:http://dx.doi.org/10.1155/2013/170417
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author Yanink Caro-Vega
Patricia Volkow
Juan Sierra-Madero
M. Arantxa Colchero
Brenda Crabtree-Ramírez
Sergio Bautista-Arredondo
author_facet Yanink Caro-Vega
Patricia Volkow
Juan Sierra-Madero
M. Arantxa Colchero
Brenda Crabtree-Ramírez
Sergio Bautista-Arredondo
author_sort Yanink Caro-Vega
collection DOAJ
description Background. Universal access to antiretroviral therapy (ARVT) started in Mexico in 2001; no evaluation of the features of ARVT prescriptions over time has been conducted. The aim of the study is to document trends in the quality of ARVT-prescription before and after universal access. Methods. We describe ARVT prescriptions before and after 2001 in three health facilities from the following subsystems: the Mexican Social Security (IMSS), the Ministry of Health (SSA), and National Institutes of Health (INS). Combinations of drugs and reasons for change were classified according to current Mexican guidelines and state-of-the-art therapy. Comparisons were made using χ2 tests. Results. Before 2001, 29% of patients starting ARVT received HAART; after 2001 it increased to 90%. The proportion of adequate prescriptions decreased within the two periods of study in all facilities (P value < 0.01). The INS and SSA were more likely to be prescribed adequately (P value < 0.01) compared to IMSS. The distribution of reasons for change was not significantly different during this time for all facilities (P value > 0.05). Conclusions. Universal ARVT access in Mexico was associated with changes in ARVT-prescription patterns over time. Health providers’ performance improved, but not homogeneously. Training of personnel and guidelines updating is essential to improve prescription.
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spelling doaj-art-e80c86e7993449fe8fda66dc377cc41e2025-08-20T02:22:15ZengWileyAIDS Research and Treatment2090-12402090-12592013-01-01201310.1155/2013/170417170417Did Universal Access to ARVT in Mexico Impact Suboptimal Antiretroviral Prescriptions?Yanink Caro-Vega0Patricia Volkow1Juan Sierra-Madero2M. Arantxa Colchero3Brenda Crabtree-Ramírez4Sergio Bautista-Arredondo5National Institute of Public Health, Health Economics Division, Avendia Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, 62100 Cuernavaca, MOR, MexicoInstituto Nacional de Cancerologia, Infectious Diseases Department, Avenida San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080 Mexico City, DF, MexicoNational Institute of Medical Sciences and Nutrition, Salvador de Zubirán Unidad del Paciente Ambulatorio (UPA), 5to Piso Vasco de Quiroga No. 15, Col. Sección XVI, Tlalpan, 14000 Mexico City, DF, MexicoNational Institute of Public Health, Health Economics Division, Avendia Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, 62100 Cuernavaca, MOR, MexicoNational Institute of Medical Sciences and Nutrition, Salvador de Zubirán Unidad del Paciente Ambulatorio (UPA), 5to Piso Vasco de Quiroga No. 15, Col. Sección XVI, Tlalpan, 14000 Mexico City, DF, MexicoNational Institute of Public Health, Health Economics Division, Avendia Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, 62100 Cuernavaca, MOR, MexicoBackground. Universal access to antiretroviral therapy (ARVT) started in Mexico in 2001; no evaluation of the features of ARVT prescriptions over time has been conducted. The aim of the study is to document trends in the quality of ARVT-prescription before and after universal access. Methods. We describe ARVT prescriptions before and after 2001 in three health facilities from the following subsystems: the Mexican Social Security (IMSS), the Ministry of Health (SSA), and National Institutes of Health (INS). Combinations of drugs and reasons for change were classified according to current Mexican guidelines and state-of-the-art therapy. Comparisons were made using χ2 tests. Results. Before 2001, 29% of patients starting ARVT received HAART; after 2001 it increased to 90%. The proportion of adequate prescriptions decreased within the two periods of study in all facilities (P value < 0.01). The INS and SSA were more likely to be prescribed adequately (P value < 0.01) compared to IMSS. The distribution of reasons for change was not significantly different during this time for all facilities (P value > 0.05). Conclusions. Universal ARVT access in Mexico was associated with changes in ARVT-prescription patterns over time. Health providers’ performance improved, but not homogeneously. Training of personnel and guidelines updating is essential to improve prescription.http://dx.doi.org/10.1155/2013/170417
spellingShingle Yanink Caro-Vega
Patricia Volkow
Juan Sierra-Madero
M. Arantxa Colchero
Brenda Crabtree-Ramírez
Sergio Bautista-Arredondo
Did Universal Access to ARVT in Mexico Impact Suboptimal Antiretroviral Prescriptions?
AIDS Research and Treatment
title Did Universal Access to ARVT in Mexico Impact Suboptimal Antiretroviral Prescriptions?
title_full Did Universal Access to ARVT in Mexico Impact Suboptimal Antiretroviral Prescriptions?
title_fullStr Did Universal Access to ARVT in Mexico Impact Suboptimal Antiretroviral Prescriptions?
title_full_unstemmed Did Universal Access to ARVT in Mexico Impact Suboptimal Antiretroviral Prescriptions?
title_short Did Universal Access to ARVT in Mexico Impact Suboptimal Antiretroviral Prescriptions?
title_sort did universal access to arvt in mexico impact suboptimal antiretroviral prescriptions
url http://dx.doi.org/10.1155/2013/170417
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