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Lessons from Early Adoption of DTG in Kenya: Aligning Clinical Decisions to Supply Chain Realities

This article discusses the lessons learned from the early adoption of DTG in Kenya, including aligning clinical decisions with supply chain realities, involving PLHIV in decision-making, strengthening pharmacovigilance systems, and addressing signal of risk/data assessments.

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Lessons from Early Adoption of DTG in Kenya: Aligning Clinical Decisions to Supply Chain Realities

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  1. KENYA Dr. Evelyn Muthoni Karanja AIDS 2018 WHO ARV guidelines satellite 23 July 2018

  2. Lessons from early adoption of DTG • Aligning clinical decisions to supply chain realities as the country transitions to new ARV products • Phased approach in “few facilities; few patients” introducing new ARV products • Program data on acceptability, adverse drug reactions, treatment outcomes Ford et al, AIDS 2018; Rosen et al Plos Med 2016

  3. Lessons from early adoption of DTG • Involving the PLHIV and their representatives in decision making • Strengthening the pharmacovigilance systems • Capacity building of service providers key in early adoption of a new drug Ford et al, AIDS 2018; Rosen et al Plos Med 2016

  4. How Kenya addressed signal of risk / data assessments • Oversight from a multi- agency Core working group to guide program response • Risk communication materials for PLHIV and HCWs developed • Case based management package to support clinical decisions on DTG • Rapid assessment on DTG use in the 24 phase in facilities conducted Ford et al, AIDS 2018; Rosen et al Plos Med 2016

  5. KENYA’S BACKGROUND Rapid Assessment (2/52);Cross section Retrospective and Prospectivestudy Launch of DTG Aug 18 Oct 18 July 18 2017 May 2019 May 2018 International Advisories: Potential Safety Concerns In Pregnancy Release and dissemination of National ARV Guidelines Ford et al, AIDS 2018; Rosen et al Plos Med 2016

  6. Future approaches on the role of DTG in Kenya • Revision and dissemination of the 2018 Treatment Guidelines – TLE and TLD as first line • Strengthening RH/HIV integration • Scale up pre-conception care and pregnancy intention assessment in routine services • Rapid surveillance of outcomes among women exposed to DTG vs EFV peri-conceptionally • Active adverse drug reaction surveillance and reporting for new ARV products

  7. ACKNOWLEDGEMENTS Ford et al, AIDS 2018; Rosen et al Plos Med 2016

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