Palliative care as an essential component of the HIV care continuum

The Lancet has published a new Review that summarises the epidemiology of HIV in relation to mortality, and the symptoms and concerns of people with AIDS and those living with HIV who have either related or unrelated advanced comorbidities.

The review also identifies  gaps in person-centred care, and presents evidence for effective models of care to address these. It also details the policies that prompt governments and health systems to respond to the palliative care needs of their population. The Review concludes with evidence-based recommendations to improve the delivery of, and access to, high-quality HIV care until the end of life, reducing unnecessary suffering while optimising person-centred outcomes.

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Summary

Although antiretroviral therapy has reduced mortality among people with HIV, inadequate treatment coverage, ageing, and the increasing incidence of organ failure and malignancies mean that high-quality care should include care at the end of life. This Review summarises the epidemiology of HIV in relation to mortality, and the symptoms and concerns of people with AIDS and those living with HIV who have either related or unrelated advanced comorbidities. In response to the evidence of a need for palliative care, the principles and practice of palliative care are described, and the evidence for its effectiveness and cost-effectiveness is appraised. The core practices of palliative care offer a mechanism to enhance the person-centred nature of HIV care; I identify the gaps in this type of care, and present evidence for effective models of care to address these. I detail the policies that prompt governments and health systems to respond to the palliative care needs of their population. Finally, I conclude this Review with evidence-based recommendations to improve the delivery of, and access to, high-quality HIV care until the end of life, reducing unnecessary suffering while optimising person-centred outcomes.

Full reference:

Harding, R. | 2018 | Palliative care as an essential component of the HIV care continuum | The Lancet HIV | Volume 0 | Issue 0 | DOI: https://doi.org/10.1016/S2352-3018(18)30110-3

The Lancet  is available to Rotherham NHS staff, via OpenAthens

 

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Hospice network must change ‘death house’ perception, academics tells MPs

University of Liverpool  |June 2018 | Hospice network must change ‘death house’ perception, academics tells MPs

Marketing experts from the University of Liverpool’s Management School have studied hospices and palliative care for the last four years. Academics Dr Philippa Hunter-Jones and Dr Lynn Sudbury-Riley argue that their research shows  hospices must market themselves and their services more effectively in order to improve the experience of end of life care for both patients and families.

They cite how their data shows the general public have a lack of knowledge about the services available to the general public and  how to access these services. The pair’s findings also highlight misconceptions about the term palliative, and a lack of emphasis on the importance of care at this life stage for the families of patients and the patients themselves (Source: University of Liverpool)

The academics were recently invited to Westminster to share their research with the All-party Parliamentary Group (APPG) Hospice and Palliative Care Inquiry into Improving Access to Hospice and Palliative Care.

The full news story is available from the University of Liverpool 

Unequal access to hospice care across England

Patients with incurable illnesses, among them dementia, liver failure  are not receiving hospice care soon enough finds a Leeds University study. The NIHR funded study, which is also the first of its kind to look at this issue is (via Leeds University

The researchers examined data from about one third of the UK’s hospices, including patient records of more than 42,000 people who died in 2015 with a progressive, advanced disease, after receiving community or inpatient palliative care at a hospice included in the study.

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Among their key findings are that patients with cancer were admitted for hospice care 53 days before dying, for patients without cancer this was later with a referral 27 days before death.  The team also identified variation across the coutnry with patients in the North admitted later than those in the South, Midlands and East of England.

 

Lead author of the study Dr Matthew Allsop said, “There are misconceptions held by the public and healthcare professionals about what palliative care is, who it is for, and when people can benefit from access to it.

“Palliative care is for any person diagnosed with a terminal illness, not just those with cancer. It aims to help patients and their families achieve the best quality of life through treating or managing physical symptoms, and helping with any psychological, social or spiritual needs (Source: Univeristy of Leeds).

The research has now been published in Palliative Medicine, the article can be read in full via Sage

Related: NIHR NIHR research highlights disparities in end-of-life hospice care