INTEGRATE Joint Action was launched in 2017 and executed over a 45 months period within the framework of the European Commissions’ Health Programme 2014-2020. The overall objective of INTEGRATE was to explore approaches to integrated early diagnosis and linkage to prevention and care of HIV, viral hepatitis, TB and STIs. The broader aim was to inform best policy and clinical practice to ensure continuity of care and integrated service provision for HIV and other STIs and foster shifts from single to multi-disease approaches. National Ministries of Health in 16 European Union (EU) and neighbouring countries nominated 29 organisations (from non-governmental institutions (NGOs) to public health institutes and hospitals), to form a consortium.
The approach in INTEGRATE has been to explore how effective tools for diagnosis and linkage to prevention and care for one disease can be used for other diseases and for multi-disease approaches; the applied methodology was to review existing tools and then adapt and pilot these tools in other/additional disease areas for an integrated approach.
To achieve the objectives, INTEGRATE implemented activities in four key thematic areas:
Integrated testing in community and health care facilities
INTEGRATE has piloted integrated testing, i.e. testing for multiple infections, in both community settings and in health care facilities with focus on test accessibility and missed opportunities. Pilots have proven that multi-disease approaches are feasible and allow for an optimization of resources and a more effective way of approaching, linking and retaining vulnerable people in care with a people centred approach.
Combination prevention
The combination prevention activities in INTEGRATE focused on partner notification and the development of a web and mobile application – named “RiskRadar” – designed to enhance the effectiveness of combination prevention by integrating HIV, hepatitis, STIs and TB in a single user-friendly information and communication technology (ICT) tool – the first of its kind.
Find here the RiskRadar app versions for Android & iOS
Country responses – how to foster collaborations across diseases areas
Country level policies and practices of testing and care for HIV, viral hepatitis and STIs fail to keep pace with European recommendations on integration across diseases. To support and foster national level changes, INTEGRATE arranged a series of national multi-stakeholder meetings as platforms for national level discussions. The meetings proved great interest and support for integrating services across disease specialties, but found that implementation of actual changes is often slowed or hindered by practical challenges, silo-structures in regulatory, legal and financial frameworks.
Findings and lessons learned from INTEGRATE have been published in a BMC infectious Disease supplement. Find the full content of the supplement here.
Tools and best practice cases for integrated multi-disease testing can be found on Eurotest website here.
For more information about INTEGRATE and final output go to the project websitehttps://integrateja.eu or contact integrate.rigshospitalet@regionh.dk.