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Related Experiment Videos

Starting or changing therapy - a prospective study exploring antiretroviral decision-making.

J S Fehr1, D Nicca, P Sendi

  • 1Division of Infectious Diseases, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.

Infection
|August 11, 2005
PubMed
Summary

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Patient readiness significantly influences decisions about starting or changing antiretroviral therapy (ART) for HIV. Shared decision-making between patients, physicians, and nurses is crucial for successful ART initiation and adherence.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Clinical Medicine

Background:

  • Determining the optimal timing for initiating or modifying antiretroviral therapy (ART) for HIV infection is critical.
  • Patient readiness is a key factor in ART treatment decisions, as no definitive time point exists for initiation.
  • This study evaluated patient readiness for starting or changing ART.

Purpose of the Study:

  • To assess patient readiness for initiating or altering antiretroviral therapy (ART).
  • To investigate the role of shared decision-making in ART treatment choices.
  • To understand patient and healthcare provider perspectives on ART initiation and changes.

Main Methods:

  • Prospective, observational, multicenter study involving HIV-infected patients starting or changing ART.

Related Experiment Videos

  • Inclusion of treating physicians and nurses in assessing shared decision-making and treatment status.
  • Evaluation of qualitative aspects, expected treatment decisions, and treatment status after 3 months.

    • Main Results:

    • Of 34 patients considered for starting ART, 79% were willing, and 78% initiated therapy within 3 months; depression was linked to lower readiness.
    • Of 41 patients considered for changing ART, 85% were willing, and 94% changed therapy within 3 months.
    • Patients perceived decisions as shared, reported high satisfaction (71%), and valued understanding and being understood; physicians overestimated treatment initiation/changes.

    Conclusions:

    • Patients actively participate in shared decision-making regarding ART during consultations.
    • Successful ART decisions involve contributions from patients, physicians, and nurses.
    • Healthcare providers should incorporate patients' expertise and perspectives into ART decision-making processes.