Edinburgh Napier University

  Background/aims: Despite treatment advances, people living with HIV (PLWH) continue to experience distressing physical, psychological, social and spiritual symptoms and concerns, which impact on their quality of life. Limited research has considered person-centred care (PCC) for PLWH in low or middle-income settings, we therefore aimed to develop and test the feasibility of a novel community-based person-centred intervention in terms of participant recruitment and retention, intervention delivery and acceptability, and to estimate the potential effect size of the intervention
Methods: Findings from an initial qualitative interview study of PLWH and healthcare professionals (HCP) were mapped onto a PCC theory in an intervention expert development workshop. A parallel feasibility cluster randomised controlled trial (cRCT) was conducted and randomly allocated clusters (1:1) either to standard care or to intervention (a 3-day intervention training for HCP; a holistic assessment tool for physical, psychological, social and spiritual wellbeing assessment; collaborative care planning and delivery; and ongoing supervision for HCP). The primary outcome was trial recruitment and retention
Results: Of the n=83 PLWH screened, n=60 were enrolled and n=30 were allocated to each cluster. 87% recruitment rate was achieved within 6weeks, and a retention rate of 97%after 4months follow-up. The intervention was delivered with fidelity and a post-trial interviews with HCP and PLWH revealed a general acceptability of the intervention. Potential effect sizes and 95% confident interval (CI) for all outcome measures used at final timepoint were: APCA POS [0.7 (95% CI 0.17 to 1.23)]; MOSHIV [0.7 (95% CI 0.17 to 1.23)]; Patient Experience Questionnaire [0.8 (95% CI 0.27 to 1.31)]; CARE Measure [1.0 (95% CI 0.45 to 1.55)], and Positive Outcomes [0.7 (95% CI 0.17 to 1.23)]. A priori feasibility criteria were met
Conclusions: Results confirm the feasibility and justify a definitive cRCT of the community-based enhanced care intervention for PLWH