Journal article
Early Use of the Palliative Approach to Improve Patient Outcomes in HIV Disease: Insights and Findings From the Care and Support Access (CASA) Study 2013-2019
American journal of hospice & palliative medicine, Vol.38(4), pp.332-339
04/01/2021
DOI: 10.1177/1049909120951129
PMID: 32851870
Abstract
Young men of color who have sex with men (yMSM) living with human immunodeficiency virus (HIV) in syndemic environments have been difficult-to-retain in care resulting in their being at-risk for poor health outcomes despite availability of effective once-daily antiretroviral treatment (ART). Multiple methods have been implemented to improve outcomes for this cohort; none with sustainable results. Outpatient HIV staff themselves may be a contributing factor. We introduced multidisciplinary staff to the concept of using a palliative approach early (ePA) in outpatient HIV care management to enable them to consider the patient-level complexity of these young men. Young MSM (18-35 years of age) enrolled in and cared for at the intervention site of the Care and Support Access Study (CASA), completed serial surveys over 18 months. Patients' Global and Summary quality of life (QoL) increased during the study at the intervention site (IS) where staff learned about ePA, compared with patients attending the control site (CS) (p=.021 and p=.018, respectively). Using serial surveys of staff members, we found that in the era of HIV disease control, outpatient staff are stressed more by environmental factors than by patients' disease status seen historically in the HIV epidemic. A Community Advisory Panel of HIV stakeholders contributed to all phases of this study and altered language used in educational activities with staff members to describe the patient cohort.
Details
- Title: Subtitle
- Early Use of the Palliative Approach to Improve Patient Outcomes in HIV Disease: Insights and Findings From the Care and Support Access (CASA) Study 2013-2019
- Creators
- Carla S. Alexander - University of Maryland, BaltimoreVictoria H. Raveis - Psychosocial Research Unit on Health, Aging and Community, 70241New York University, New York, NY, USA.Daniel Karus - New York UniversityMonique Carrero-Tagle - New York UniversityMei Ching Lee - Univ Maryland, Sch Nursing, Baltimore, MD 21201 USAGregory PappasKashelle Lockman - Iowa State UniversityRebecca Brotemarkle - University of Maryland, BaltimorePeter Memiah - University of Maryland, BaltimoreIla Mulasi - University of Maryland, BaltimoreBasile Mian Hossain - Morgan State UniversityChristopher Welsh - University of Maryland, BaltimoreYvonne Henley - State of Maryland Quality, Baltimore, MD, USA.Leslie Piet - Johns Hopkins HospitalSabrina N'Diaye - State Maryland Mental Hlth, Baltimore, MD USARenard Murray - University of Maryland, BaltimoreDavid HaltiwangerCarlton Ray Smith - Ctr Black Equ, Washington, DC USAColin Flynn - Maryland Department of HealthRobert Redfield - CDC FoundationCaroline L. Silva - University of Maryland, BaltimoreAnthony Amoroso - University of Maryland, BaltimorePeter Selwyn - Montefiore Medical Center
- Resource Type
- Journal article
- Publication Details
- American journal of hospice & palliative medicine, Vol.38(4), pp.332-339
- Publisher
- Sage
- DOI
- 10.1177/1049909120951129
- PMID
- 32851870
- ISSN
- 1049-9091
- eISSN
- 1938-2715
- Number of pages
- 8
- Grant note
- IH-1304-7297 / Patient Centered Outcomes Research Institute, Inc.
- Language
- English
- Date published
- 04/01/2021
- Academic Unit
- Pharmacy Practice and Science; Office of Consultation and Research in Medical Education; Internal Medicine
- Record Identifier
- 9984365896902771
Metrics
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