The Influence of Patient Experience with Healthcare on the Health-Related Quality of Life of People Living with HIV: An Observational Cross-Sectional Survey

Abstract

Introduction Patient experience is central to the quality of healthcare delivery, showing positive associations with several outcome measures. The main objectives of this study are to analyze the influence of patient experience on the health-related quality of life in people living with HIV and the role played by treatment complexity and clinical care. Methods We conducted a cross-sectional survey with 467 patients with HIV. We used the Instrument for Evaluation of the Experience of Chronic Patients and the Health-related Quality of Life Questionnaire (EQ-5D-5L). We analyzed a predictive model through the partial least squares (PLS) method. Results The patient self-management scores showed the highest positive relationship with the patient’s health-related quality of life ( β = 0.24, β = 0.32, p < 0.0001). Patients’ treatment complexity had a negative influence on health-related quality of life ( β = − 0.21, β = − 0.28, p < 0.0001). The complexity of clinical care had negative effects on health-related quality of life, both directly ( β = − 0.37, β = − 0.19, p < 0.0001) and through its negative influence on the productive interactions with healthcare professionals ( β = − 0.21, p < 0.0001) and patient self-management factors ( β = − 0.21, p < 0.0001). The effects of patient experience dimensions on their health-related quality of life were higher in people living with HIV > 50 years old ( p < 0.05). Conclusions Patient experience mainly influenced the health-related quality of life of older people living with HIV. The treatment and clinical care complexity played an important role in degrading the patients' experience and their quality of life. More integrated care would benefit the health-related quality of life of people living with HIV. Funding This project was funded by Merck Sharp & Dohme, Spain. Electronic supplementary material The online version of this article (10.1007/s40121-019-0252-3) contains supplementary material, which is available to authorized users.

Intersectionality of stigmas and health-related quality of life in people ageing with HIV in China, Europe, and Latin America

“…[78][79][80] The increased complexity of the treatment and clinical care of older people with HIV has also been highlighted. 81 All these variables were inversely associated with HRQOL. 27,79,80,82,83 A study in France showed that nearly half of older individuals with HIV surveyed were affected by social deprivation and lack of social care; in addition, social deprivation was associated with alcohol misuse, depression, and multimorbidity.…”

“…76,77,87 Furthermore, people ageing with HIV seemed to have developed adaptative coping strategies, a positive self-concept, good emotional status, meaning in life, positive attitudes towards the future, resilience, social support, and productive interactions with health-care professionals. 59,81,[88][89][90][91] In the ASTRA study in the UK, the prevalence of depression and anxiety in people with HIV tended to decrease with age, and the prevalence of functional problems tended to increase; however, rather than age, it was found that the duration of HIV infection influenced the physical and mental health of older people with HIV. 14 Other studies found that a longer time since HIV diagnosis was strongly associated with a higher prevalence of depression, anxiety, symptom distress, and functional problems, 92 and decreased HRQOL.…”

Ways of coping mediate the relationship between self‐efficacy for managing HIV and acceptance of illness among people living with HIV

“…Self‐efficacy for managing disease (how well an individual perceives their personal capability for taking specific actions to manage disease; Bandura, Barbaranelli, Caprara, & Pastorelli, 1996; Lorig, Sobel, Ritter, Laurent, & Hobbs, 2001) has been shown to have a close relationship with adaptation outcomes. Self‐efficacy for managing HIV is of great importance for adaptation outcomes for PLWH, as it is vital to decisions about the range of their self‐management activities, which are in turn strongly linked to enhanced quality of life, less adverse symptoms and better ART adherence (Ahmed, Farooqui, Syed Sulaiman, Hassali, & Lee, 2019; Angwenyi, Aantjes, Bunders‐Aelen, Lazarus, & Criel, 2019; Finkelstein‐Fox, Park, & Kalichman, 2020; Fuster‐RuizdeApodaca et al., 2019). One pilot experiment showed that PWLH, with higher self‐efficacy for physical exercise, managed their health effectively, since they were likely to engage in physical activities (Mabweazara, Leach, Ley, & Smith, 2018).…”

Past and future of HIV infection. A document based on expert opinion

“…The most prevalent symptoms found in other countries with large cohorts of PLHIV are sleep problems, muscle pain, fatigue, sadness, anxiety, sexual problems, and abdominal pain/distension [50]. SEISIDA studies [51,52] show data in line with these findings, as the most prevalent symptoms in PLHIV in Spain are the same, and the most bothersome are sleep and sexual problems. The general health and symptoms experienced by PLHIV relate to many aspects of the process of living with HIV; the experiences, thoughts and emotions involved.…”