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Integrated Care as a Model for Interprofessional Disease Management and the Benefits for People Living with HIV/AIDS

Introduction: Today, antiretroviral therapy (ART) is effectively used as a lifelong therapy to treat people living with HIV (PLWH) to suppress viral replication. Moreover, PLWH need an adequate care strategy in an interprofessional, networked setting of health care professionals from different disci...

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Autores principales: Beichler, Helmut, Grabovac, Igor, Dorner, Thomas E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965658/
https://www.ncbi.nlm.nih.gov/pubmed/36834069
http://dx.doi.org/10.3390/ijerph20043374
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author Beichler, Helmut
Grabovac, Igor
Dorner, Thomas E.
author_facet Beichler, Helmut
Grabovac, Igor
Dorner, Thomas E.
author_sort Beichler, Helmut
collection PubMed
description Introduction: Today, antiretroviral therapy (ART) is effectively used as a lifelong therapy to treat people living with HIV (PLWH) to suppress viral replication. Moreover, PLWH need an adequate care strategy in an interprofessional, networked setting of health care professionals from different disciplines. HIV/AIDS poses challenges to both patients and health care professionals within the framework of care due to frequent visits to physicians, avoidable hospitalizations, comorbidities, complications, and the resulting polypharmacy. The concepts of integrated care (IC) represent sustainable approaches to solving the complex care situation of PLWH. Aims: This study aimed to describe the national and international models of integrated care and their benefits regarding PLWH as complex, chronically ill patients in the health care system. Methods: We conducted a narrative review of the current national and international innovative models and approaches to integrated care for people with HIV/AIDS. The literature search covered the period between March and November 2022 and was conducted in the databases Cinahl, Cochrane, and Pubmed. Quantitative and qualitative studies, meta-analyses, and reviews were included. Results: The main findings are the benefits of integrated care (IC) as an interconnected, guideline- and pathway-based multiprofessional, multidisciplinary, patient-centered treatment for PLWH with complex chronic HIV/AIDS. This includes the evidence-based continuity of care with decreased hospitalization, reductions in costly and burdensome duplicate testing, and the saving of overall health care costs. Furthermore, it includes motivation for adherence, the prevention of HIV transmission through unrestricted access to ART, the reduction and timely treatment of comorbidities, the reduction of multimorbidity and polypharmacy, palliative care, and the treatment of chronic pain. IC is initiated, implemented, and financed by health policy in the form of integrated health care, managed care, case and care management, primary care, and general practitioner-centered concepts for the care of PLWH. Integrated care was originally founded in the United States of America. The complexity of HIV/AIDS intensifies as the disease progresses. Conclusions: Integrated care focuses on the holistic view of PLWH, considering medical, nursing, psychosocial, and psychiatric needs, as well as the various interactions among them. A comprehensive expansion of integrated care in primary health care settings will not only relieve the burden on hospitals but also significantly improve the patient situation and the outcome of treatment.
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spelling pubmed-99656582023-02-26 Integrated Care as a Model for Interprofessional Disease Management and the Benefits for People Living with HIV/AIDS Beichler, Helmut Grabovac, Igor Dorner, Thomas E. Int J Environ Res Public Health Review Introduction: Today, antiretroviral therapy (ART) is effectively used as a lifelong therapy to treat people living with HIV (PLWH) to suppress viral replication. Moreover, PLWH need an adequate care strategy in an interprofessional, networked setting of health care professionals from different disciplines. HIV/AIDS poses challenges to both patients and health care professionals within the framework of care due to frequent visits to physicians, avoidable hospitalizations, comorbidities, complications, and the resulting polypharmacy. The concepts of integrated care (IC) represent sustainable approaches to solving the complex care situation of PLWH. Aims: This study aimed to describe the national and international models of integrated care and their benefits regarding PLWH as complex, chronically ill patients in the health care system. Methods: We conducted a narrative review of the current national and international innovative models and approaches to integrated care for people with HIV/AIDS. The literature search covered the period between March and November 2022 and was conducted in the databases Cinahl, Cochrane, and Pubmed. Quantitative and qualitative studies, meta-analyses, and reviews were included. Results: The main findings are the benefits of integrated care (IC) as an interconnected, guideline- and pathway-based multiprofessional, multidisciplinary, patient-centered treatment for PLWH with complex chronic HIV/AIDS. This includes the evidence-based continuity of care with decreased hospitalization, reductions in costly and burdensome duplicate testing, and the saving of overall health care costs. Furthermore, it includes motivation for adherence, the prevention of HIV transmission through unrestricted access to ART, the reduction and timely treatment of comorbidities, the reduction of multimorbidity and polypharmacy, palliative care, and the treatment of chronic pain. IC is initiated, implemented, and financed by health policy in the form of integrated health care, managed care, case and care management, primary care, and general practitioner-centered concepts for the care of PLWH. Integrated care was originally founded in the United States of America. The complexity of HIV/AIDS intensifies as the disease progresses. Conclusions: Integrated care focuses on the holistic view of PLWH, considering medical, nursing, psychosocial, and psychiatric needs, as well as the various interactions among them. A comprehensive expansion of integrated care in primary health care settings will not only relieve the burden on hospitals but also significantly improve the patient situation and the outcome of treatment. MDPI 2023-02-15 /pmc/articles/PMC9965658/ /pubmed/36834069 http://dx.doi.org/10.3390/ijerph20043374 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Beichler, Helmut
Grabovac, Igor
Dorner, Thomas E.
Integrated Care as a Model for Interprofessional Disease Management and the Benefits for People Living with HIV/AIDS
title Integrated Care as a Model for Interprofessional Disease Management and the Benefits for People Living with HIV/AIDS
title_full Integrated Care as a Model for Interprofessional Disease Management and the Benefits for People Living with HIV/AIDS
title_fullStr Integrated Care as a Model for Interprofessional Disease Management and the Benefits for People Living with HIV/AIDS
title_full_unstemmed Integrated Care as a Model for Interprofessional Disease Management and the Benefits for People Living with HIV/AIDS
title_short Integrated Care as a Model for Interprofessional Disease Management and the Benefits for People Living with HIV/AIDS
title_sort integrated care as a model for interprofessional disease management and the benefits for people living with hiv/aids
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965658/
https://www.ncbi.nlm.nih.gov/pubmed/36834069
http://dx.doi.org/10.3390/ijerph20043374
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