Abboah-Offei Mary, Bristowe Katherine, Vanderpuye-Donton Naa Ashiley, Ansa Gloria, Oppong-Agyei Yaa Dabboah, Abas Melanie, Higginson Irene, Harding Richard
Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
West Africa AIDS Foundation, Accra, Ghana.
AIDS Care. 2020 May;32(sup2):107-118. doi: 10.1080/09540121.2020.1739217. Epub 2020 Mar 13.
Person-centred care (PCC) for people living with HIV (PLWH) is a global goal for WHO and the UNAIDS strategy. We aimed to develop a novel person-centred intervention for community providers, test the feasibility of participant recruitment and retention, intervention delivery and to establish acceptability. Findings from qualitative interviews with PLWH and healthcare professionals were mapped onto a PCC theory in an expert intervention development workshop. A parallel feasibility cluster randomised controlled trial (cRCT) was conducted. We randomly assigned clusters (1:1) either to intervention or to standard care. The primary outcome was trial recruitment and retention. We screened 83 PLWH, enrolled 60 with 30 allocated to each arm. Recruitment and retention rates were 87% and 97%, respectively. Potential effect size achieved at final timepoint: a measure of person-centred outcomes [0.7 (95% CI 0.17-1.23) < 0.001]; MOSHIV [0.7 (95% CI 0.17-1.23) < 0.001]; Patient Experience Questionnaire [0.8 (95% CI 0.27-1.31) < 0.001]; CARE Measure [1.0 (95% CI 0.45-1.55) < 0.001], POSITIVE OUTCOMES [0.7 (95% CI 0.17-1.23) < 0.001]. Post-trial interviews revealed general acceptability of the intervention. The results confirm the feasibility and justify a definitive cRCT of the enhanced care intervention to improve person-centred outcomes for PLWH.Trial registration number ISRCTN13630241.
以患者为中心的艾滋病毒感染者（PLWH）护理是世界卫生组织（WHO）和联合国艾滋病规划署（UNAIDS）战略的全球目标。我们旨在为社区服务提供者开发一种新型的以患者为中心的干预措施，测试参与者招募和保留、干预措施实施的可行性，并确定其可接受性。在一次专家干预措施开发研讨会上，我们将对PLWH和医疗保健专业人员进行定性访谈的结果映射到以患者为中心的护理理论上。我们进行了一项平行可行性整群随机对照试验（cRCT）。我们将整群（1:1）随机分配到干预组或标准护理组。主要结果是试验招募和保留情况。我们筛查了83名PLWH，招募了60名，每组分配30名。招募率和保留率分别为87%和97%。在最终时间点实现的潜在效应量：以患者为中心的结果指标[0.7（95%置信区间0.17 - 1.23）＜0.001]；MOSHIV[0.7（95%置信区间0.17 - 1.23）＜0.001]；患者体验问卷[0.8（95%置信区间0.27 - 1.31）＜0.001]；CARE量表[1.0（95%置信区间0.45 - 1.55）＜0.001]，积极结果[0.7（95%置信区间0.17 - 1.23）＜0.001]。试验后访谈显示该干预措施总体上是可接受的。结果证实了该干预措施的可行性，并证明有必要对强化护理干预措施进行确定性的cRCT，以改善PLWH以患者为中心的结果。试验注册号ISRCTN13630241。
