[Abstract] Patients’ preferences for the delivery of HIV services: a qualitative study of the roles of secondary versus primary care

Pollard, A, Llewellyn, C, Cooper, V, Perry, N, Nixon, E, Youssef, E, Clatworthy, J, Fisher, M, Miners, A, Lagarde, M, Sabin, C, Sachikonye, M and Foreman, C (2015) [Abstract] Patients’ preferences for the delivery of HIV services: a qualitative study of the roles of secondary versus primary care. In: Unset.

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Background: Various models of shared-care have evolved over recent years to support increasing numbers of HIV positive patients who have age-related comorbidities. These models include the wider involvement of GPs, similar to the integrated model applied to other long term conditions in the NHS. Contrary to Department of Health recommendations, these changes in service design have been developed in the absence of evidence on patients’ preferences. This study examined patients’ preferences for the future delivery of services.

Methods: Twelve focus groups of HIV positive patients were conducted in community settings in south east England. Groups were quota sampled on age, sex, sexual orientation, and African/non-African ethnicity. Data were analysed using Framework Analysis.

Results: 74 respondents (61% male). Participants’ concerns about changes to their healthcare were focused on the following main areas:
• perceptions that GPs are likely to have low levels of HIV knowledge and skills or lack confidence to treat HIV positive patients
• a lack of care coordination and poor communication between services
• concerns about disclosure of HIV in non-HIV services
• a lack of understanding of the social/emotional experience of living with HIV.
There was a strong preference for maintaining all care within specialist HIV clinics among participants with longer histories of HIV and/or comorbidities. Participants were typically unclear or confused about who had responsibility for prescribing, referrals and care coordination. The value of electronic patient records to facilitate communication was balanced against risks to

Conclusion: The findings of this large qualitative study highlight areas of concern and aspects of care that are important to people with HIV. They suggest that any future reconfiguration of services to meet the needs of an ageing population needs to have patient views at the centre. These findings have been used to inform the design of an ongoing Discrete Choice Experiment which will determine the relative importance to patients of different service characteristics.

Item Type: Conference or Workshop Item (Paper)
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Brighton and Sussex Medical School > Division of Medical Education
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0440 Study and teaching. Research
Depositing User: Phoenix Marshall
Date Deposited: 19 Sep 2016 15:34
Last Modified: 25 Sep 2017 10:23
URI: http://srodev.sussex.ac.uk/id/eprint/63417

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