Evidence map›Paper›PMID 40403479›Full record

Trial reportValue in health regional issues2025

Cost-Effectiveness of an Enhanced Patient Care Intervention for Improving Viral Suppression Among Kenyan Adults Living With HIV.

Jenna Fritz, Juddy Wachira, Marta Wilson-Barthes, Catherine Kafu, Diana Chemtai, Becky Genberg, Omar Galárraga

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Value in health regional issues, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jenna FritzBloomberg School of Public Health Johns Hopkins University, Baltimore, MD, USA.
Juddy WachiraDepartment of Behavioral Sciences, Moi University, Eldoret, Kenya.
Marta Wilson-BarthesDepartment of Epidemiology, Brown University, Providence, RI, USA. Electronic address: marta_wilson-barthes@brown.edu.
Catherine KafuDepartment of Behavioral Sciences, Moi University, Eldoret, Kenya; Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
Diana ChemtaiAcademic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
Becky GenbergAcademic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
Omar GalárragaAcademic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya; Department of Health Services, Policy and Practice, Brown University, Providence, RI, USA.

Funding

Translational ScienceP30AI042853 · NIAID · MIRIAM HOSPITAL · PI CURT G BECKWITH, DEBBIE M. CHENG · 1998 to 2026
$51.7M
Tracking and Evaluation CoreU54GM115677 · NIGMS · BROWN UNIVERSITY · PI ROUNDS, SHARON IRENE SMITH · 2016 to 2025
$45.0M
Feasibility and acceptability of Enhanced Patient Care (EPC) for adult HIV patients with unsuppressed viral loads in western KenyaK43TW010684 · FIC · MOI UNIVERSITY COLLEGE OF HEALTH SCIENCES · PI WACHIRA, JUDDY · 2018 to 2022
$553k
FIC NIH HHS K43 TW010684NIAID NIH HHS P30 AI042853NIGMS NIH HHS U54 GM115677
6 · The paper itself

Abstract

objectivesPatient-centered interventions can improve care engagement and treatment adherence for people living with HIV (PLWH). Yet, evidence on their cost-effectiveness remains sparse, hindering their prioritization over alternative models. This study estimated the cost-effectiveness of a patient-centered intervention for improving viral suppression among PLWH in western Kenya.

methodsWe analyzed the cost-effectiveness of an enhanced patient-centered (EPC) intervention via a randomized pilot trial among 328 PLWH in 2 rural clinics. The EPC arm included clinician-patient continuity, treatment dialogue, and flexible scheduling. The provider-patient communication (PPC) arm provided training on motivational interviewing. The standard of care arm provided patient-specific interventions to promote viral suppression. Costs were aggregated across the 2 clinics and measured from a societal perspective, including patient time, transportation, and medication. The incremental cost per disability-adjusted life year averted was calculated based on patient virologic failure risk, HIV transmissions averted, and life expectancy. Key parameters were varied by ±25% to examine uncertainty in incremental cost-effectiveness ratios.

resultsCompared with standard HIV care, both the EPC intervention and PPC training alone were more cost-effective at various willingness-to-pay thresholds. Providing PPC training alone was the dominant strategy (more effective and less costly) compared with the EPC intervention at $97.72 per HIV infection averted and $4.44 per disability-adjusted life year averted. Both interventions were cost savings when factoring in lifetime HIV treatment cost averted.

conclusionsPatient-centered care models may be highly cost-effective for improving treatment outcomes among PLWH. These encouraging results warrant further testing in fully powered clinical trials.

Indexed as

Cost-Effectiveness AnalysisHIV InfectionsPatient CareViral LoadAdultAnti-HIV AgentsFemaleHumansKenyaMaleMiddle AgedPatient-Centered CarePilot ProjectsAnti-HIV Agentscost-effectivenessEast AfricaHIVpatient-centered careviral suppression

Identifiers

PMID40403479
PMCPMC12354026

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.