Satisfaction with care in HIV-infected patients treated with long-term follow-up antiretroviral therapy: the role of social vulnerability

Abstract

The aim of this study was to determine factors associated with complete satisfaction with the care provided (satisfaction with physicians and satisfaction with services and organization) among HIV-infected patients followed up in the French ANRS CO8 APROCO-COPILOTE cohort. Analyses focused on cross-sectional data collected during the ninth year of cohort follow-up. Satisfaction with care, sociodemographic characteristics, and behavioral data were collected using self-administered questionnaires, while clinical data were derived from medical records. Complete satisfaction with care was defined as being 100% satisfied. Two logistic regression models were used to identify predictors of (1) complete satisfaction with physicians (n=404) and (2) complete satisfaction with services and organization (n=396). Sixteen percent of patients were completely satisfied with physicians, while 15.9% were completely satisfied with services and organization. Being older and reporting fewer discomforting antiretroviral therapy (ART) side effects were factors independently associated with complete satisfaction with both physicians and services and organization. Strong support from friends and absence of hepatitis C (HCV) co-infection were independently associated with complete satisfaction with physicians, while strong support from one's family and comfortable housing conditions were independently associated with complete satisfaction with services and organization. Even after nine years of follow-up, social vulnerabilities still strongly influence HIV-infected patients' interactions with the health care system. Day-to-day experience with the disease, including perceived treatment side effects, appears to play a key role in the quality of these interactions. More attention should be given to patient satisfaction, especially for socially vulnerable patients, in order to avoid potentially detrimental consequences such as poor adherence to ART.

Comparison of satisfaction with care between two different models of HIV care delivery in St. Petersburg, Russia

“…Nevertheless, the overwhelming majority of the HIV/AIDS patients in St. Petersburg reported high levels of overall satisfaction with care regardless of where they obtained that care. The overall high level of satisfaction is consistent with other studies of patient satisfaction studies (Dang, Westbrook, Rodriguez-Barradas, & Giordano, 2012; Crow, Gage, Hampson, Hart, & Kimber, 2002; Préau et al, 2012, Devnani, Gupta, Wanchu, & Sharma, 2012; Sood et al, 2013). In multivariate analysis, satisfaction with care was strongly associated only with the type of clinic and with Patient-Doctor Relationship scores.…”

“…Several studies have suggested that patients’ satisfaction with providers affects their behavior, including adherence to therapy and intention to return to the clinic (Dang, Westbrook, Black, Rodriguez-Barradas, & Giordano, 2013; Beach, Keruly, & Moore, 2006; Préau et al, 2012). However, it is unclear which aspect of providing health care most strongly influences patients’ evaluation.…”

Is Clinical Practice Concordant with the Changes in Guidelines for Antiretroviral Therapy Initiation during Primary and Chronic HIV-1 Infection? The ANRS PRIMO and COPANA Cohorts

“…These patient-related risk factors were living at friends’ or family’s place, and a lower educational level. These social conditions might reflect psychosocial frailty already identified as a risk factor of poor adherence to ART [36], [37]. In France, access to HIV drugs and related care is free and in our study we did not find that an economic barrier such as unemployment was a risk factor for not receiving timely treatment.…”

How are women living with HIV in France coping with their perceived side effects of antiretroviral therapy? Results from the EVE study

“…Other socioeconomic indicators, such as a lack of stable housing, have also been shown to be associated with lower adherence to HIV therapy [39]. Furthermore, social vulnerability negatively impacts satisfaction with physicians [40] and, as a result, physician-patient communication, which is a factor associated with retention to care [21]. More attention should be given to helping socially vulnerable WLWHIV access symptom- management strategies in order to prevent health-care inequalities.…”