AIDS Research and Treatment Cluster RCT Cohort study Table 1: Study characteristics of included articles. Inputs Training (i) 1-week theoretical, (ii) 2-months practice, on the job training Outcomes Method Salary Equipment Yes (i) Mobile device 208 patients stable and at (ii) Mobile phone least 3 months on ART were randomly assigned to: community-based care (N = 96) and clinic-based care (N = 112): (i) 50% reduction clinical visits when in community-based care (ii) 5% LFU rate in both arms at 12 months follow-up time (i) Information session on day of inclusion in a CAG (ii) 6 monthly interactive group sessions (iii) No formal training No No 1,301 patients at least 6 months stable on ART were enrolled CAG. After median follow-up time of 12,9 months: (i) 0.2% LFU (ii) 2.3% died (iii) 97.5% retained 4 Country Tasks of PLWHA Community care coordinators, each responsible for 8–20 adults: (i) Monthly drug Kenya [20, 21] reﬁlls (ii) Pill count (iii) Monitoring (iv) Referral of problem cases PLWHA organized in community ART groups in which 6 members are Mozambique responsible for [22] (i) Monthly drug reﬁlls (ii) Pill count (iii) Self-reporting (iv) Self-referral RCT: randomised controlled trial; PLWHA: people living with HIV/AIDS; LFU: lost to followup; CAG: community ART groups. at the clinic. Every six months, all members are invited for a routine clinic visit, CD4 check and an interactive group session. This dynamic is driven by mutual support and the need to obtain an easier reﬁll, integrated in the patients’ daily life in the community. No ﬁnancial or material incentives were given. Of the patients in CAG, 97.5% were retained after a median follow-up time of 12.9 months [22]. Both programs ﬁt in the concept of the expert patient, as PLWHA were motivated to acquire skills to manage their condition and to support fellow peers, using their day-to-day experience of living with HIV (Table 2). In both programs PLWHA functioned as partner in care and a bidirectional referral system was installed, as sick patients were referred to the clinic and the community network was used for tracking of patients lost to followup. In both Kenya and Mozambique PLWHA acquired skills to provide ART, to refer sick patients to the clinic, to report on treatment outcomes, and to give psychosocial support [20–22]. In Kenya, CCC were trained in medical and psy- chosocial tasks to become expert patients. Being PLWHA, they were able to understand and resolve psychosocial bar- riers to adherence of their peers in the community to an extent that was not obtained during consultations at the health facility [20, 21]. In Mozambique, all patients in CAG were engaged on a voluntary basis and capacitated to par- ticipate in the daily care of themselves and their peers. PLWHA self-formed support groups and met monthly in the community to share information and problem-solving skills regarding physical and psychosocial issues. Major problems were reported to the health staﬀ and feedback was debated at the next meeting in the community, resulting in an information loop between health facilities and the com- munity [22]. In Kenya the CCC beneﬁtted from a formal training and were remunerated as CHW. There was a solid monitoring system in place to facilitate regular control and supervision by the healthcare workers, and CCC were held accountable for their daily performances [20, 21]. In Mozambique the peers were involved from the start in the process of planning and implementation of the CAG dynamic, which resulted in a feeling of ownership and motivated the PLWHA to stay involved in the CAG dynamic. Aﬀordability and accessibility of ART reﬁll was improved for CAG members. These direct beneﬁts were a straightforward incentive to motivate PLWHA to become engaged in their own care [22]. In both countries the motivation for expert patients to take responsibility was strengthened through the proximity with their fellow peers in the community, as they added their day-to-day expertise of living with HIV to their acquired knowledge. This resulted in unique relationships among peers, built on common needs, conﬁdence, and reciprocity [20–22]. CCC in Kenya were perceived by the patients as their advocates, a relationship which enabled them to bring practical solutions for psychosocial problems related to adhe- rence where the traditional care providers had failed, and to ensure the communication between the PLWHA in the community and the healthcare workers [20, 21]. 4. Discussion 4.1. Expert Patient in Chronic Lifelong Conditions. The in- crease in chronic lifelong conditions (CLLCs), such as