Engler Kim, Lessard David, Lebouché Bertrand
Chronic Viral Illness Service, Montreal Chest Institute, McGill University Health Centre, Local D02.4110, Glen Site, 1001 Décarie Boulevard, Montreal, QC, H4A 3J1, Canada.
Research Institute, McGill University Health Centre, Montreal, QC, Canada.
Patient. 2017 Apr;10(2):187-202. doi: 10.1007/s40271-016-0195-7.
The use of patient-reported outcome (PRO) measures to provide added feedback to health providers is receiving interest as a means of improving clinical care and patient outcomes, and contributing to more patient-centered care. In human immunodeficiency virus (HIV), while PROs are used in research, their application in clinical practice has been limited despite their potential utility. PRO selection is an important consideration when contemplating their use. As past reviews of PROs in HIV have focused on particular areas (e.g. disability, satisfaction with care), a more comprehensive review could better inform on the available instruments and their scope. This article reviews HIV-specific PROs to produce an inventory and to identify the central concepts targeted over time. Seven databases were searched (HAPI, MEDLINE, PsychINFO, PubMed, EMBASE, CINAHL, Google Scholar), generating 14,794 records for evaluation. From these records, 117 HIV-specific PROs were identified and categorized based on a content analysis of their targeted concept: Health-Related Quality of Life (23; 20 %), ART and Adherence-Related Views and Experiences (19; 16 %), Healthcare-Related Views and Experiences (15; 13 %), Psychological Challenges (12; 10 %), Symptoms (12; 10 %), Psychological Resources (10; 9 %), HIV Self-Management and Self-Care (8; 7 %), HIV-Related Stigma (8; 7 %), Body and Facial Appearance (4; 3 %), Social Support (3; 3 %), Sexual and Reproductive Health (2; 2 %), and Disability (1; 1 %). This review highlights the variety and evolution of HIV-specific PROs, with the arrival of seven categories of PROs only after the advent of highly-active antiretroviral therapy. Our inventory also offers a useful resource. However, the interest of further HIV-specific PRO development should be explored in sexual health, which received little independent attention.
使用患者报告结局（PRO）指标为医疗服务提供者提供额外反馈，作为改善临床护理和患者结局以及促进更以患者为中心的护理的一种方式，正受到关注。在人类免疫缺陷病毒（HIV）领域，虽然PRO指标在研究中被使用，但其在临床实践中的应用尽管具有潜在效用却一直有限。在考虑使用PRO指标时，指标选择是一个重要的考量因素。由于过去对HIV领域PRO指标的综述集中在特定领域（如残疾、对护理的满意度），更全面的综述可以更好地了解可用工具及其范围。本文综述了针对HIV的特定PRO指标，以编制一份清单并确定随着时间推移所针对的核心概念。检索了七个数据库（HAPI、MEDLINE、PsychINFO、PubMed、EMBASE、CINAHL、谷歌学术），生成了14794条记录以供评估。从这些记录中，识别出117个针对HIV的特定PRO指标，并根据对其目标概念的内容分析进行分类：与健康相关的生活质量（23个；20%）、抗逆转录病毒治疗（ART）及依从性相关的观点和经历（19个；16%）、与医疗保健相关的观点和经历（15个；13%）、心理挑战（12个；10%）、症状（12个；10%）、心理资源（10个；9%）、HIV自我管理和自我护理（8个；7%）、与HIV相关的耻辱感（8个；7%）、身体和面部外观（4个；3%）、社会支持（3个；3%）、性与生殖健康（2个；2%）以及残疾（1个；1%）。本综述突出了针对HIV的特定PRO指标的多样性和演变，七类PRO指标是在高效抗逆转录病毒治疗出现后才出现的。我们的清单也提供了一个有用的资源。然而，在性健康方面应探索进一步开发针对HIV的特定PRO指标的意义，因为性健康很少受到独立关注。
