Nurses start prescribing ARVs in South Africa

13 December 2007

Three clinics involved in the STRETCH programme in the Free State are the first clinics in the country to have registered nurses re-prescribing antiretrovirals (ARVs) to patients who have been stabilized on treatment.

The aim of the STRETCH, or Streamlining Tasks and Roles to Expand Treatment and Care for HIV, programme is to improve ARV treatment access and waiting times without lowering the currently high standard of care for people receiving ARVs.

STRETCH is being implemented in 3 phases in selected Free State clinics. During Phase 1 all nurses received outreach training in HIV and TB care. Phase 2 involves nurses represcribing ARVs to stable patients and started in October/ November. Phase 3 will see them initiate ARVs in selected adults and is expected to start in January 2008.

Dr Kerry Uebel who leads the project in the Free State says “Feedback from the clinics has been good. A few clinics have had difficulty getting going, some because they couldn’t get prescriptions to their hospital pharmacy and others because they weren’t sure how to identify patients who were coming up for a 6 month visit as they all had appointments at the (doctor-run) treatment site. But mostly we have discussed and found ways to solve these problems. Many patients have expressed their appreciation of STRETCH as they no longer have to travel to the treatment site and spend the whole day just to get the doctor to sign their treatment.”

The National Department of Health is looking to the project to provide answers and interventions to the question of task shifting, which is being promoted as the solution to expanding treatment access.

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