TY - JOUR
T1 - Integrating Early Palliative Care for Patients With HIV
T2 - Provider and Patient Perceptions of Symptoms and Need for Services
AU - Lofgren, Sarah
AU - Friedman, Rachel
AU - Ghermay, Rahwa
AU - George, Maura
AU - Pittman, John Richard
AU - Shahane, Amit
AU - Zeimer, Dorothy
AU - Del Rio, Carlos
AU - Marconi, Vincent C.
N1 - Publisher Copyright:
© 2014, The Author(s) 2014.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Increasingly clinicians are using palliative care to address the symptomatic and psychosocial effects of disease often missed by routine clinical care, termed “early” palliative care. Within an inner-city medical center, we began a program to integrate early palliative care into HIV inpatient care. Patient symptom burden and desired services were assessed and compared to provider perceptions of patient’s needs. From 2010-2012, 10 patients, with a median CD4+ T-cell count of 32.5 cells/μL, and 34 providers completed the survey. Providers ranked their patients’ fatigue, sadness, anxiety, sexual dysfunction, and body image significantly higher than patients it for themselves. Patients ranked medical care, pharmacy, social work, physical therapy, and housing as significantly more important to them than providers estimated them to be. These differences may reflect the fact that physicians often overlook patients’ unmet basic needs. Early palliative care may narrow this gap between providers’ and patients’ perceptions of needs through good communication and targeting barriers, such as housing instability, which are vital to overcome for consistent long-term follow up.
AB - Increasingly clinicians are using palliative care to address the symptomatic and psychosocial effects of disease often missed by routine clinical care, termed “early” palliative care. Within an inner-city medical center, we began a program to integrate early palliative care into HIV inpatient care. Patient symptom burden and desired services were assessed and compared to provider perceptions of patient’s needs. From 2010-2012, 10 patients, with a median CD4+ T-cell count of 32.5 cells/μL, and 34 providers completed the survey. Providers ranked their patients’ fatigue, sadness, anxiety, sexual dysfunction, and body image significantly higher than patients it for themselves. Patients ranked medical care, pharmacy, social work, physical therapy, and housing as significantly more important to them than providers estimated them to be. These differences may reflect the fact that physicians often overlook patients’ unmet basic needs. Early palliative care may narrow this gap between providers’ and patients’ perceptions of needs through good communication and targeting barriers, such as housing instability, which are vital to overcome for consistent long-term follow up.
KW - HIV
KW - health services
KW - health services accessibility
KW - palliative care
KW - social services
KW - symptom assessment
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U2 - 10.1177/1049909114550391
DO - 10.1177/1049909114550391
M3 - Article
C2 - 25216735
AN - SCOPUS:84945929131
SN - 1049-9091
VL - 32
SP - 829
EP - 834
JO - American Journal of Hospice and Palliative Medicine
JF - American Journal of Hospice and Palliative Medicine
IS - 8
ER -