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Patient Centered Care for Persons with HIV Disease: Protocol Review for CASA Study (Care and Support Access) Early in Chronic Disease Management
Carla S Alexander1*, Victoria H Raveis2, Daniel G Karus2, Mei Ching Lee3, Monique Carrero Tagle2, Rebecca Brotemarkle3, Gregory Pappas5 and Peter Selwyn6
1Medical Director for Palliative Care, UMMC-MidTown Campus (UMMC MTC), Baltimore, USA
2New York University Cardiology and Comprehensive Care, New York, USA
3University of Maryland Baltimore School of Nursing, Organizational Systems and Adult Health, Baltimore, USA
4University of Maryland Baltimore School of Nursing, Baltimore, USA
5Food and Drug Administration Center for Devices and Radiological Health, USA
6Director of the Palliative Care Program, Montefiore Medical Center Montefiore Medical Center, NY 10467, USA
- *Corresponding Author:
- Carla S Alexander, MD, FAAHPM
Assistant Professor of Medicine University of Maryland Baltimore School of Medicine
Institute of Human Virology - Clinical Care and Research Division
Medical Director for Palliative Care UMMC-MidTown Campus, Baltimore, USA
Tel: +1 410 328 7129
Fax: +1 410 328 4430
E-mail: calexand@medicine.umaryland.edu
Received date: February 28, 2017; Accepted date: March 21, 2017; Published date: March 25, 2017
Citation: Alexander CS, Raveis VH, Karus DG, Lee MC, Tagle MC, et al. (2017) Patient Centered Care for Persons with HIV Disease: Protocol Review for CASA Study (Care and Support Access) Early in Chronic Disease Management. J Palliat Care Med 7:300. doi: 10.4172/2165-7386.1000300
Copyright: © 2017 Alexander CS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: In the US, more than 1.2 million adults are living with human immunodeficiency virus (HIV); gay and bisexual men account for 82% of new diagnoses annually. Young men of color account for 67% of this total. Despite advances in disease control, lack of retention in care itself remains a barrier and how outpatient staff members impact this has not been investigated. The palliative approach is patient-centered care targeting "relief of suffering" and "quality of life." This paper describes the original protocol for the Care and Support Access Study (CASA) where outpatient HIV staff members are challenged to improve outcomes for young men who have sex with men (yMSM) by integrating the palliative approach early (ePA) with HIV care delivery.
Methods: The hypothesis is that ePA can favorably impact outcomes for yMSM in one HIV clinic compared with treatment as usual (TAU) at a second clinic. In the era of HIVdisease control, we use a quasi-experimental design with mixed methods to compare patient-level outcomes at 2 HIV clinics. The intervention fosters incorporation of the ePA with care provision using didactic and iterative education. We survey HIV staff members with regard to stress of care-giving. Qualitative interviews will highlight impact of the experience.
Objectives: This paper reviews the aims of the study including: 1) compare outcomes of yMSM receiving care from staff using the ePA to those receiving TAU; 2) compare work-related staff stress at a clinic receiving the ePA with staff providing standard HIV outpatient care; and 3) refine, deliver and determine the acceptability and applicability of interdisciplinary professional education to deliver the ePA in HIV management.
Discussion: We will measure the impact of the ePA on care delivery relative to patientcentered benefits. Lessons learned can contribute to a model for working with diverse patients facing challenging life transitions.
