HIV Management and treatment. Where are we at and where are we going? The Queensland experience.

Abstract

After 7 years of operation of the 'Prescribers' Course in HIV Medicine', designed to provide accreditation for prescribing of HIV antiretroviral therapies in Queensland, 78 medical practitioners had completed training. A review of course attendees describes the current status of those 44 who are not currently accredited to prescribe HIV antiretroviral therapies and the already mentioned survey describes the current status of those 34 who are currently accredited to prescribe HIV antiretroviral therapies. In 2004, 30/34 community-based medical practitioners accredited to prescribe HIV antiretroviral therapies in Queensland responded to a survey about their prescribing practices. Of the 30 respondents: 4 had no patients with HIV; 7 managed patients with HIV but do not prescribe, and 19 prescribed HIV antiretroviral therapies. The survey was designed to support debate on models of care in HIV medicine at the annual HIV prescriber update organised by the HIV & HCV Education Projects of the School of Medicine. The focus of the debate was on the current system of education / assessment / accreditation, conducted within a broader discussion of various 'models of care' such as formal shared care in HIV medicine; accreditation to prescribe only maintenance scripts; specialist only care as they operate in Queensland. The debate also included discussions about the management and care of people with HIV in Queensland. One primary issue of concern was the continuing suitability of the education / assessment / accreditation system for prescribers of HIV antiretroviral therapies in Queensland. Participants in the discussion reached consensus that the present system, although rigorous and set at a high standard, met the needs of medical practitioners seeking more training in HIV Medicine. This presentation will examine both the findings of the survey that prompted the discussion and the range of 'models of care' raised in the discussion: eg - formal shared care in HIV medicine; accreditation to prescribe only maintenance scripts; specialist only care (and who is a 'specialist) etc.