Cresswell F V, Levett T
Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Brighton and Sussex Medical School, Brighton, UK.
HIV Med. 2017 Aug;18(7):519-524. doi: 10.1111/hiv.12481. Epub 2017 Jan 24.
There is a clear trajectory towards cohort ageing in the UK. HIV infection is associated with an increased prevalence of traditionally age-related comorbidities and geriatric syndromes. Some HIV services have been proactive in innovating models that cater for adapting needs. We aimed to describe how widespread this practice is and what form such services take.
We conducted an evaluation of the perceived need for and current provision of specialist ageing services, and the need for formal guidance on monitoring or treatment of older adults with HIV infection. A web-based questionnaire was sent to the audit lead at every British HIV Association (BHIVA)-registered HIV clinic.
A total of 102 clinics responded, with a broad geographical spread. Five of the 102 clinics have a clinician with an interest in ageing. Two dedicated HIV ageing services exist, practising different models. A quarter (23 of 98; 23%) of clinics reported a need for an ageing service, with three in development. The majority (65 of 95; 68%) supported dedicated guidance for monitoring in older adults, but fewer (39 of 94; 41%) felt that dedicated guidance on treatment was necessary.
We identified two existing and three proposed HIV ageing services. Another 20 clinics (20%) reported an unmet need for a specialist ageing service, suggesting that complex older adults may pose a management challenge. This is the first survey of its kind to attempt to describe the current landscape and opinion around such services. HIV-infected cohorts will continue to age and current models of care may be insufficient, which should prompt services, their users and commissioners to consider what models may best fit current and future demand.
在英国，队列老龄化有一个清晰的发展轨迹。艾滋病毒感染与传统上与年龄相关的合并症和老年综合征的患病率增加有关。一些艾滋病毒服务机构积极创新模式以满足不断变化的需求。我们旨在描述这种做法的普及程度以及此类服务的形式。
我们对专科老龄化服务的感知需求、当前提供情况以及对艾滋病毒感染老年患者监测或治疗的正式指导需求进行了评估。向每个英国艾滋病毒协会（BHIVA）注册的艾滋病毒诊所的审计负责人发送了一份基于网络的问卷。
共有102家诊所做出回应，分布广泛。102家诊所中有5家有对老龄化问题感兴趣的临床医生。存在两种专门的艾滋病毒老龄化服务模式，且做法不同。四分之一（98家诊所中的23家；23%）的诊所报告需要老龄化服务，其中3家正在筹备中。大多数（95家诊所中的65家；68%）支持针对老年人监测的专门指导，但较少（94家诊所中的39家；41%）认为有必要提供针对治疗的专门指导。
我们确定了现有的两种和提议的三种艾滋病毒老龄化服务。另外20家诊所（20%）报告了对专科老龄化服务的未满足需求，这表明复杂的老年患者可能带来管理挑战。这是同类首次试图描述此类服务当前情况和观点的调查。艾滋病毒感染人群将继续老龄化，当前的护理模式可能不足，这应促使服务机构、其使用者和委托方考虑哪种模式最适合当前和未来的需求。
