Hi John
this situation has been problematic for many years with various models used to quickly link patients to care. Some are given a 7 or 30 day supply upon release. Other patients try to reconnect with their previous site of care but again not easy…insurance, travel etc. With a high barrier to resistance with INSTs. I would argue it's much better to be on ART than off and never Not (double negative here ) resume anyone's ART .
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Jeffrey T. Kirchner, DO, FAAFP, AAHIVS
Lancaster PA
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Original Message:
Sent: 08-07-2024 16:17
From: John Phoenix
Subject: When is it ok to not restart meds
I am working in corrections, and many of the people I see are only taking medication for a few days while they are in custody. Upon release, they do not continue medication due to a variety of barriers, mainly a lack of engagement in care with a community provider.
In these situations, where patients might be taking meds for a week or two, then off for a couple of months, then back on for a few days, etc., I am looking for a guideline or articles supporting not restarting meds because of a risk of resistance development from lack of ability to adhere due to health disparities and Social Determinants of Health that are beyond the patient's ability to control. Many of these patients are in and out of custody several times yearly. I understand it is not ideal, but thoughts?
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John Phoenix
Las Vegas NV
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