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Adherence to Recommendations from Comprehensive Geriatric Assessment of Older Individuals with HIV

Christiana Bitas1, Sian Jones2, Harjot Kaur Singh2

  • 11 Department of Obstetrics and Gynecology, Tufts University Medical Center, Boston, MA, USA.

Journal of the International Association of Providers of AIDS Care
|February 26, 2019
PubMed

Insights

Comprehensive geriatric assessment (CGA) for older HIV patients showed low adherence to recommendations. Providers reported feasibility as a key barrier, indicating a need for further research to improve outcomes.

Area of Science:

  • Gerontology
  • Infectious Diseases
  • Public Health

Background:

  • Older adults living with HIV often have complex health needs.
  • Comprehensive Geriatric Assessment (CGA) is designed to address multifaceted geriatric syndromes.
  • The effectiveness of CGA in HIV clinics remains under-explored.

Purpose of the Study:

  • To evaluate the impact and adherence to recommendations from CGA for older patients receiving care at an HIV clinic.
  • To identify barriers to implementing CGA recommendations in this specific patient population.

Main Methods:

  • Retrospective cohort study analyzing medical records of 76 older HIV patients who underwent CGA between June 2013 and July 2017.
  • Anonymous surveys administered to physicians and social workers to assess the perceived impact of CGA and implementation barriers.
  • Analysis of recommendations, counseling instances, direct actions, and adherence rates.

Main Results:

  • A total of 184 recommendations, 54 counseling instances, and 11 direct actions were identified.
  • Overall adherence to CGA recommendations was low, at 32.8% (patient-directed: 34.9%, provider-directed: 31.7%).
  • No demographic or CGA variables were significantly associated with adherence. Providers reported feasibility as the primary barrier to implementation.

Conclusions:

  • While CGA generates numerous recommendations for older HIV patients, adherence rates are low.
  • Lack of feasibility is a significant barrier hindering the implementation of CGA recommendations.
  • Further research is essential to optimize CGA strategies for improving health outcomes in this vulnerable population.

Keywords:
HIV positiveadherencecomprehensive geriatric assessment

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