Shared Care Unit: a new model of coordinating HIV care between Primary Settings and Hospital

Barba, Olga; Clusa, Thais; Menacho, Ignacio; Sequeira, Ethel; Moreno, Laura; Gonzalez, Eva; Freixa, Xavier; Cayuelas, Laia; Muñoz, Susana Rodríguez; Fernandez, Emma; Leal, Lorna; García, Felipe Andreo; León, Agathe

doi:10.5334/ijic.2748

Cited by 1 publication

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“…Studies show that particularly vulnerable populations (sex workers, intravenous drug users with and without methadone programs, and homeless people) with HIV do not always benefit optimally from ART without ongoing support from professionals [ 1 , 99 , 100 ]. Barba et al, (2016) [ 101 ] describe the coordination of patient-centered care for PLWH between primary care and the hospital setting, where numerous medical comorbidities with polypharmacy are successfully treated [ 102 ]. Further, integrated care has been shown to be particularly important in PLWH in the palliative setting in relation to stigma and poverty, as well as severe untreated pain, with people in the study describing a longing for death due to the pain [ 103 ].…”

Section: Discussionmentioning

confidence: 99%

Integrated Care as a Model for Interprofessional Disease Management and the Benefits for People Living with HIV/AIDS

Beichler

Grabovac

Dörner

2023

IJERPH

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Introduction: Today, antiretroviral therapy (ART) is effectively used as a lifelong therapy to treat people living with HIV (PLWH) to suppress viral replication. Moreover, PLWH need an adequate care strategy in an interprofessional, networked setting of health care professionals from different disciplines. HIV/AIDS poses challenges to both patients and health care professionals within the framework of care due to frequent visits to physicians, avoidable hospitalizations, comorbidities, complications, and the resulting polypharmacy. The concepts of integrated care (IC) represent sustainable approaches to solving the complex care situation of PLWH. Aims: This study aimed to describe the national and international models of integrated care and their benefits regarding PLWH as complex, chronically ill patients in the health care system. Methods: We conducted a narrative review of the current national and international innovative models and approaches to integrated care for people with HIV/AIDS. The literature search covered the period between March and November 2022 and was conducted in the databases Cinahl, Cochrane, and Pubmed. Quantitative and qualitative studies, meta-analyses, and reviews were included. Results: The main findings are the benefits of integrated care (IC) as an interconnected, guideline- and pathway-based multiprofessional, multidisciplinary, patient-centered treatment for PLWH with complex chronic HIV/AIDS. This includes the evidence-based continuity of care with decreased hospitalization, reductions in costly and burdensome duplicate testing, and the saving of overall health care costs. Furthermore, it includes motivation for adherence, the prevention of HIV transmission through unrestricted access to ART, the reduction and timely treatment of comorbidities, the reduction of multimorbidity and polypharmacy, palliative care, and the treatment of chronic pain. IC is initiated, implemented, and financed by health policy in the form of integrated health care, managed care, case and care management, primary care, and general practitioner-centered concepts for the care of PLWH. Integrated care was originally founded in the United States of America. The complexity of HIV/AIDS intensifies as the disease progresses. Conclusions: Integrated care focuses on the holistic view of PLWH, considering medical, nursing, psychosocial, and psychiatric needs, as well as the various interactions among them. A comprehensive expansion of integrated care in primary health care settings will not only relieve the burden on hospitals but also significantly improve the patient situation and the outcome of treatment.

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