New findings from a Randomised Control Trial of integrated palliative care delivered by existing outpatient nurses to HIV patients on treatment has found significant improvements in psychosocial problems, quality of life and psychological morbidity.
The aim of current global policy is that by 2020, 90% of people with HIV will be tested, of these 90% will be on treatment, and of those on treatment 90% will have viral suppression.
This poses a huge challenge to health services, especially as prior evidence from East Africashowed a high burden of psychosocial problems among people with HIV, that this is evident from the point of diagnosis and a systematic reviewidentified a high prevalence of depression, anxiety and perceived stigma globally for people on HIV treatment .
The TOPcare trial, published this week in Lancet HIV, found that a simple training programme in the principles and practice of palliative care that was delivered to existing HIV outpatient nurses significantly improved quality of life, and reduced psychosocial problems and psychiatric morbidity for patients on treatment for the virus.
This offers a promising model for health services around the world that will face an increasing patient load with such problems.
Dr Richard Harding, Reader in Palliative Care at the Cicely Saunders Institute and co-author of the paper, said: “As health services try to identify new and better ways to make care more person-centred, TOPcare provides an entirely novel approach. This robust evidence demonstrates that the principles and practice of palliative care really can be integrated into routine care alongside treatment.
“Policy, treatment guidelines and practice should reflect this simple approach to meet patients’ high burden of psychosocial as well as physical problems. Here we have shown benefit for people with HIV, but there is great potential for people with other long-term conditions.”
The full paper is available to download free of charge from The Lancet website.