HIV, Aging, and Advance Care Planning: Are We Successfully Planning for the Future?
HIV, Aging, and Advance Care Planning: Are We Successfully Planning for the Future?
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DOI：
10.1089/jpm.2011.0510
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发表时间：
2012-10-01
影响因子：
2.8
通讯作者：
Campbell, Thomas B.
中科院分区：
文献类型：
--
作者：
Erlandson, Kristine M.;Allshouse, Amanda A.;Campbell, Thomas B.
导言：艾滋病毒感染者提前护理计划（ACP）完成率的研究早于艾滋病毒流行的“灰色化”。我们试图研究目前的ACP完成率和因素的影响完成之间HIV infected persons.Methods：HIV-1血清阳性的人年龄在45-65岁的有效抗逆转录病毒治疗至少6个月参加了横断面调查。ACP的可能性进行了评估的人口统计学和临床特征，比值比（OR）和95%Wald置信区间（CI）进行了测试，并调整了性别。年龄≥ 55岁的人（OR 2.8; CI 1.6，5.0; p < 0.001）、男性（OR 4.1; CI 1.8，9.3; p = 0.004）和受过高等教育的人（OR 2.2; CI 1.3，4.0; p = 0.007）更有可能完成ACP。发生心脏事件的患者更有可能完成ACP（OR 5.5; CI 1.6，25; p = 0.03），尽管在调整性别后这种影响减弱（OR 4.5; CI 0.95，21.4; p = 0.06）。诊断HIV感染超过5年与完成ACP治疗无关（OR 1.3; CI 0.7，2.7; p = 0.4）。完成和未完成记录的患者当前CD 4（+）细胞计数相似（分别为588个细胞/μ L和604个细胞/μ L; p = 0.7）。ACP的可能性没有显着差异与其他comorbidity.Discussion：不到50%的中年患者在艾滋病护理记录ACP。特别是，妇女和教育程度较低的人不完成学业的风险最大，可能需要采取干预措施，以改善ACP。
Introduction: Studies of advance care planning (ACP) completion rates in HIV-infected persons pre-date the "graying" of the HIV epidemic. We sought to examine current ACP completion rates and factors influencing completion among HIV-infected persons.Methods: HIV-1-seropositive persons aged 45-65 years on effective antiretroviral therapy for a minimum of 6 months were enrolled in a cross-sectional survey. Likelihood of ACP was assessed by demographic and clinical characteristics, tested with odds ratios (OR) and 95% Wald confidence intervals (CI), and adjusted for gender.Results: Of 238 participants, 112 (47%) completed ACP. Persons >= 55 years of age (OR 2.8; CI 1.6,5.0; p < 0.001), males (OR 4.1; CI 1.8,9.3; p = 0.004), and persons with higher education (OR 2.2; CI 1.3,4.0; p = 0.007) were more likely to have completed ACP. Persons with a cardiac event were more likely to have completed ACP (OR 5.5; CI 1.6,25; p = 0.03), although this effect was diminished after adjusting for gender (OR 4.5; CI 0.95,21.4; p = 0.06). HIV infection diagnosed for greater than 5 years was not associated with ACP completion (OR 1.3; CI 0.7,2.7; p = 0.4). Current CD4(+) cell counts were similar between those completing and not completing documentation (588 cells/mu L and 604 cells/mu L, respectively; p = 0.7). The likelihood of ACP did not significantly differ with other comorbidities.Discussion: Less than 50% of middle-aged patients in HIV care had documented ACP. In particular, women and those with lower education were at greatest risk of non-completion and may need interventions to improve ACP.