The Golden Compass Program: Overview of the Initial Implementation of a Comprehensive Program for Older Adults Living with HIV

Greene, Meredith; Myers, Janet J.; Tan, Judy Y.; Blat, Cinthia; O'Hollaren, Allison; Quintanilla, Francisco; Hsue, Priscilla Y.; Shiels, Mary; Hicks, Mary L.; Olson, Bill; Grochowski, Janet R.; Oskarsson, Jon; Havlir, Diane V.; Gandhi, Monica

doi:10.1177/2325958220935267

Cited by 16 publications

(70 citation statements)

References 44 publications

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“…Few integrated care programs for older people with HIV have been evaluated. The findings in this and in previous assessments of Golden Compass [ 15 ] are consistent with the limited literature demonstrating high patient and provider satisfaction with care models that incorporated geriatric medicine in HIV care [ 22 , 23 ]. Principles of geriatric medicine emphasize a comprehensive problem-solving approach to sustaining functional ability and improving quality of life [ 22 , 23 ].…”

Section: Discussionsupporting

confidence: 89%

“…Golden Compass at Ward 86, a safety-net outpatient HIV clinic, was developed in response to the need for a broader care approach with older people with HIV (Fig. 1 ) [ 14 , 15 ]. The Golden Compass multidisciplinary team includes a HIV geriatrician, a cardiologist, a pharmacist, and a social worker.…”

Section: Introductionmentioning

confidence: 99%

“…The Golden Compass multidisciplinary team includes a HIV geriatrician, a cardiologist, a pharmacist, and a social worker. Additional services include specialist referrals and navigation; classes on improving functional status and cognition [ 14 , 15 ].

Fig.…”

Section: Introductionmentioning

confidence: 99%

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Examining the Impact of the Golden Compass Clinical Care Program for Older People with HIV: A Qualitative Study

et al. 2021

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The combined burden of geriatric conditions, comorbidities, and HIV requires a model of HIV care that offers a comprehensive clinical approach with people 50 years or older with HIV. Golden Compass is an outpatient, multidisciplinary HIV-geriatrics program with an onsite HIV geriatrician, cardiologist, pharmacist, and social worker, offering specialist referrals, care navigation, and classes on improving functional status and cognition. Participants (13 patients and 11 primary care providers) were recruited using a non-probability sampling method to participate in semi-structured interviews on the perceived impact of Golden Compass on care delivered to older people with HIV. Interviews were transcribed verbatim and framework analysis used to analyze the transcripts. The perceived impacts of Golden Compass by patients and providers were organized by the Compass points (Northern: Heart and Mind, Eastern: Bones and Strength, Southern: Navigation and Network, Western: Dental, Hearing, and Vision). Overall, patients valued the focus on functional health and whole-person care, leading to greater trust in the ability of providers. Providers gained new skills through the geriatrics, cardiology and/or pharmacist consultations. The HIV-geriatrics specialty approach of Golden Compass improved functional ability and quality of life for older adults with HIV. Few integrated care programs for older people with HIV have been evaluated. This study adds to the limited literature demonstrating high patient and provider satisfaction with a HIV-care model that incorporated principles of geriatric medicine emphasizing a comprehensive approach to sustaining functional ability and improving quality of life.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Examining the Impact of the Golden Compass Clinical Care Program for Older People with HIV: A Qualitative Study

et al. 2021

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“…There is some progress in the clinical use of the CGA, which often includes geriatric referral and geriatric syndrome assessments. 128,129 Newer approaches that incorporate artificial intelligence and machine learning to omic and dataset methods in infection and integrative medicine, although early in development, appear promising. 130 None of the composite scores currently capture all the relevant biological processes to provide a holistic understanding of biological ageing either in people with HIV or in the general population.…”

Section: Can We Leverage Insights From Diagnostic and Therapeutic App...mentioning

confidence: 99%

Biological ageing with HIV infection: evaluating the geroscience hypothesis

Montano

Oursler

Sun

et al. 2022

The Lancet Healthy Longevity

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“… 17 Programs to meet needs of older people with HIV are being developed around the world. 18 Examples like the Silver Clinic in England 19 and Golden Compass in San Francisco 20 have described significant comorbidities, functional burdens, and geriatric syndromes. Functional deficits are not irreversible, and timely interventions may be able to improve quality of life.…”

Section: Introductionmentioning

confidence: 99%

Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation

Siegler¹,

Moxley²,

Glesby³

2021

HIV

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Purpose People with HIV (PWH) are living longer lives and likely experiencing accentuated aging. Comprehensive geriatric assessment (CGA) has been proposed as a way to identify and help meet each individual patient’s needs. Patients and Methods We performed a retrospective review of the results of CGA in an HIV clinic in New York City. CGA included assessment of basic and instrumental activities of daily living, screens for depression, anxiety, frailty, cognition, and quality of life, along with general discussion of concerns and goals. We compared the group of PWH referred for CGA to those of comparable age who were not referred to determine the factors that were associated with referral. We carried out a descriptive analysis of those undergoing CGA, along with regression to determine factors associated with poorer PHQ-2 depression scores and higher VACS score. Results A total of 105 patients underwent full CGA during the study period. Mean age of referred patients was 66.5 years, ranging from 50 to 84 years (SD 7.99). More than 92% were virally suppressed. Compared with their non-referred counterparts over 50, referred patients were older and had more functional comorbidities like cerebrovascular disease, neuropathy, and urinary incontinence. More than half complained of fatigue, and 2/3 noted poor memory. Almost 60% were frail or prefrail. Ninety patients were asked about their goals, and the most commonly cited were related to health or finances; fifteen patients were unable to articulate any goals. Having fewer goals and noting weight loss or fatigue were predictive of higher scores on the PHQ-2 depression screen. Conclusion Although most older PWH undergoing CGA can manage their ADL, many have concerns and deficits beyond their comorbidities. CGA offers an important window into the psychosocial concerns and needs of older PWH.

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The Golden Compass Program: Overview of the Initial Implementation of a Comprehensive Program for Older Adults Living with HIV

Cited by 16 publications

References 44 publications

Examining the Impact of the Golden Compass Clinical Care Program for Older People with HIV: A Qualitative Study

Examining the Impact of the Golden Compass Clinical Care Program for Older People with HIV: A Qualitative Study

Biological ageing with HIV infection: evaluating the geroscience hypothesis

Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation

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