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5. Third-line ART is taking new medicines, they should also concomitant medicine use, completing the
recommendation be asked whether they are experiencing TLART application form and preparing the
any new adverse effects, which should patient for a DRT. Delays can be avoided
Once the Committee has agreed upon a be reported to the doctor. These patients when complete application forms,
recommended regimen for the patient, the also need continued counselling and together with the DRT, are submitted to
TLART secretary sends an email with this adherence support, as they may be the TLART Committee, and the pharmacy
recommendation to the email address/ on the last effective line of treatment for is informed regarding the ordering of the
es supplied in the application form. It is HIV, making it important that this regimen patient’s medication.
important that the facility’s pharmacy is remains effective for as long as possible.
notified of this as they will have to procure This short synopsis on the TLART
this medication specifically for the patient. Role of the nurse: to continue monitoring programme demonstrates how vital the
the patient’s response to treatment, nurse’s role is within the multidisciplinary
Role of the nurse: to ensure that the provide adherence counselling, and team when addressing the complicated
pharmacy has received the patient’s ensure they have access to treatment needs of treatment-experienced HIV-
regimen and is procuring the medicines. support. positive patients.
To follow-up with the clinician and patient
on the date for the patient to fetch their Conclusion
medicine.
The management of patients with HIV References
6. Patient monitoring and has, for the most part, been delegated 1 George, A., Blaauw, D., Thompson, J. et al. Doctor retention
continued adherence to nurses in the PHC setting. This has and distribution in post-apartheid South Africa: tracking medical
graduates (2007–2011) from one university. Hum Resour Health
counselling been shown to improve outcomes for 17, 100 (2019). https://doi.org/10.1186/s12960-019-0439-4
patients, as well as improving access to 2 Jones M, Cameron D. Evaluating 5 years’ NIMART mentoring in
South Africa’s HIV treatment programme: Successes, challenges
and future needs. S Afr Med J 2017; 107(10):839-842
Routine monitoring should be continued these life-saving medicines. The nurse is a 3 Standard Treatment Guidelines and Essential Medicines List:
in those patients on TLART, according to fundamental part of these successes, and Primary Healthcare Level, 2020 Edition. National Department of
Health. https://www.knowledgehub.org.za/elibrary/primary-
the ART guidelines. It is desirable that their role can be extended into assisting healthcare-phc-standard-treatment-guidelines-and-essential-
4
medicines-list-south
patients that are initiated on TLART have doctors in identifying patients that are 4 ART Clinical Guidelines for the Management of HIV in Adults,
Pregnancy, Adolescents, Children, Infants and Neonates. 2019.
their VL repeated after 3 months, to check eligible for TLART, gathering important National Department of Health. https://www.knowledgehub.
org.za/elibrary/2019-art-clinical-guidelines-management-hiv-
if the treatment is working appropriately information from the patient especially adults-pregnancy-adolescents-children-infants
and their VL is decreasing. As the patient with regards to treatment history and

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