Are patient outcomes improved by models of professionally-led community HIV management which aim to be person-centred? A systematic review of the evidence

TY - JOUR

T1 - Are patient outcomes improved by models of professionally-led community HIV management which aim to be person-centred? A systematic review of the evidence

AU - Abboah-Offei, M.

AU - Bristowe, K.

AU - Harding, R.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - UNAIDS advocates person-centred care (PCC) for people living with HIV/AIDS (PLWHA) to improve outcomes and wellbeing. We appraised the evidence of person-centred models of community HIV care delivered or led by trained healthcare professionals and its impact on care outcomes. A systematic review was conducted in line with PRISMA guidance. Six electronic databases (CINAHL, Embase, PubMed, Medline, PsycINFO and Web of Science) were searched from January 1980 to April 2019. We included primary studies of any design of PCC models; for adults aged ≥15 years; that were delivered or led by trained HCP. Data were extracted including study location, design, quality, outcomes measured and effectiveness. Five out of 1393 studies met the inclusion criteria, of which four were from a high-income country and one a lower-middle income country. Of the PCC components (physical, psychological, social and spiritual wellbeing) delivered alongside HIV clinical management, one study delivered 2, two studies delivered 3 and two studies delivered all 4 components. This review highlights the lack of outcome evidence for person-centred HIV care, and of concurrent focus on all domains of concern for PLWHA within interventions. Clear articulation of the meaning, practice of PCC and implementation strategies are needed to meet policy recommendations.

AB - UNAIDS advocates person-centred care (PCC) for people living with HIV/AIDS (PLWHA) to improve outcomes and wellbeing. We appraised the evidence of person-centred models of community HIV care delivered or led by trained healthcare professionals and its impact on care outcomes. A systematic review was conducted in line with PRISMA guidance. Six electronic databases (CINAHL, Embase, PubMed, Medline, PsycINFO and Web of Science) were searched from January 1980 to April 2019. We included primary studies of any design of PCC models; for adults aged ≥15 years; that were delivered or led by trained HCP. Data were extracted including study location, design, quality, outcomes measured and effectiveness. Five out of 1393 studies met the inclusion criteria, of which four were from a high-income country and one a lower-middle income country. Of the PCC components (physical, psychological, social and spiritual wellbeing) delivered alongside HIV clinical management, one study delivered 2, two studies delivered 3 and two studies delivered all 4 components. This review highlights the lack of outcome evidence for person-centred HIV care, and of concurrent focus on all domains of concern for PLWHA within interventions. Clear articulation of the meaning, practice of PCC and implementation strategies are needed to meet policy recommendations.

KW - community-based care

KW - HIV/AIDS

KW - holistic assessment

KW - holistic care

KW - Person-centred care

UR - http://www.scopus.com/inward/record.url?scp=85088989472&partnerID=8YFLogxK

U2 - 10.1080/09540121.2020.1798865

DO - 10.1080/09540121.2020.1798865

M3 - Article

C2 - 32741201

AN - SCOPUS:85088989472

SN - 0954-0121

JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV

JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV

ER -