The Development of Service Model for Antiretroviral Treatment Service Delivery in HIV-infected/AIDS Patients at the HIV Clinic, Selaphum Hospital, Roi Et Province

Abstract

Objective : To assess quality of life, develop a model for HIV antiretroviral drug delivery services, and evaluate the outcomes of the service model among HIV-infected and AIDS patients.

Methods : This is a quasi-experimental research and development with purposive sampling among HIV-infected and AIDS patients with stable conditions, based on inclusion criteria, from February 1st to July 31st 2025. The study was divided into four phases. Data were collected from two sources: 1. demographic and clinical data from medical records and 2. quality of life measured using the Thai translation of the WHOQOL-HIV-BREF questionnaire (six dimensions). Phase 1: situation analysis by assessing quality of life using descriptive statistics. Phase 2: an appropriate service model for antiretroviral treatment service delivery was developed. Phase 3: the developed model was implemented and data were collected using the same tools and methods as in the initial phase. Phase 4: evaluation of the service model outcomes. The study compared and analyzed data using statistical methods such as Chi-square test, F-test, ANOVA, and assessed relationships using multiple linear regression.

Result : A total of 345 patients were included. At baseline (first assessment), the mean overall quality of life score was 111.50 ± 18.27 (out of a possible 155 score). After the development of three service models: 1. physician-led clinic visit 160 patients (46.38%), 2. pharmacist-led medication refills 144 patients (41.74%), and 3. the model of receiving continuous medication by mail 41 patients (11.88%), it was found that the mail-order medication dispensing option had significantly higher quality of life score than physician-led clinic visit, with a mean difference of 4.45 points (95% CI; 3.94, 4.96; p = 0.003). However, the pharmacist-led medication refills had no significant difference in quality of life scores compared to the physician-led clinic visit when confounding variables were controlled.

Conclusion : The quality of life with the model of receiving medication by mail is higher than physician-led clinic visit and pharmacist-led medication refills. Therefore, the mail-order medication dispensing model is an alternative option for implementation in clinics.