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

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.
• 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.