Improving Care for People Aging with HIV: A Collaborative Quality Improvement Approach

Area of Science:

• Geriatrics
• Infectious Diseases
• Public Health

Background:

• Nearly 60% of people with HIV in New York State are over 50.
• Aging with HIV presents unique challenges, including functional impairments.
• Existing care models may not adequately address the needs of older adults with HIV.

Purpose of the Study:

• To develop and implement a statewide quality improvement project to enhance screening for functional impairments in older adults with HIV.
• To adapt and pilot the World Health Organization's Integrated Care of Older People (ICOPE) intrinsic capacity screen for this population.

Main Methods:

• A modified ICOPE screen was piloted across 13 clinical and non-clinical sites in New York.
• Short-cycle tests of change were employed to assess screening outcomes.
• Data were collected on screening eligibility, completion rates, and referral patterns.

Main Results:

• Of 1,629 eligible individuals, 638 were screened, revealing significant needs.
• Positive screens varied from 17% for hearing to 49% for vision impairments.
• Referral rates were low (11% for memory/nutrition), with hearing loss having the highest referrals (27%).

Conclusions:

• The modified ICOPE screen effectively identified functional impairments in people aging with HIV.
• Collaboration between stakeholders, including people with lived experience, is crucial for improving care.
• The pilot demonstrated successful implementation and ongoing use of the screening tool, leading to process changes and improved quality of care.