End-of-life care for HIV-infected patients with malignancies: A questionnaire-based survey

Kojima, Yoshiyuki; Iwasaki, Nami; Yanaga, Yuriko; Tanuma, Junko; Koizumi, Yusuke; Uehira, Tomoko; Yotsumoto, Mihoko; Ajisawa, Atsushi; Hagiwara, Shotaro; Okada, Seiji; Nagai, Hirokazu

doi:10.1177/0269216316635881

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…[ 56 – 58 ] Despite this shift, there remains a low rate of palliation and hospice care for HIV patients, highlighting a need for improved end-of-life support in this population. [ 59 ] The same trend of more deaths in hospitals has been reported in a similar study that suggests that the higher rate of hospital deaths in HIV cases may stem from communication challenges and disenfranchisement reported by MSM as well as the need to initiate or modify ART for which the hospitals provide the infrastructure and expertise. [ 60 ]…”

Section: Discussionmentioning

confidence: 60%

Disparities in mortality trends of adults with HIV in the USA: A comprehensive examination across 2 decades

Ashraf,

Nadeem,

Ashfaq

et al. 2024

Medicine

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Approximately 38 million people worldwide are affected by human immunodeficiency virus (HIV), with 4000 new infections daily. While literature explores HIV mortality among the elderly in the US, there is an underrepresentation of mortality data for adults. By scrutinizing mortality trends based on demographic factors such as gender, race or ethnicity, age groups, and geographic location, the study seeks to uncover patterns that may facilitate a longitudinal perspective for tailoring interventions and allocating resources effectively. Crude death rates and age-adjusted mortality rates (AAMR) per 100,000 individuals were calculated using HIV mortality data (ICD-10 Codes B20–24) from CDC WONDER database. Permutation test was used to calculate annual percentage changes in AAMR with 95% confidence interval. Average annual percentage changes were computed as weighted average of annual percentage changes. Between 1999 to 2020, US adult HIV deaths totaled 225,396 (AAMR: 5.03), with a significantly decreasing average annual percentage changes (‐5.94). Males exhibited a 3-fold higher AAMR (7.50) than females (2.67). Non-Hispanic Blacks had the highest AAMR (21.82), while Non-Hispanic Asians had the lowest (0.67). The South and Northeast regions had the highest AAMRs (6.91 and 6.33, respectively). Notably, the District of Columbia had an alarmingly high mortality rate of 39.9, while North Dakota had the lowest (0.7). Urban regions (5.47) had double the mortality rates of rural regions (2.70). Mortality rate peaked in age groups 45 to 54 (8.65) and 35 to 44 (7.42). While overall HIV mortality is declining, disparities persist among demographics. Targeted interventions are crucial to improve preventive measures and healthcare access for disproportionately affected groups.

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Section: Discussionmentioning

confidence: 60%

Disparities in mortality trends of adults with HIV in the USA: A comprehensive examination across 2 decades

Ashraf,

Nadeem,

Ashfaq

et al. 2024

Medicine

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“…As such, this would cause the professionals’ lower likelihood of providing hospice care services for advanced HIV patients. A previous nationwide hospital survey in Japan showed that 11.2% of healthcare providers at palliative care units were not willing to provide EOL care for PLWH due to lack of knowledge and experience in treating advanced HIV patients nearing death 21. Since hospice and palliative care services are associated with improvements in quality of life among patients towards the EOL,7 it is important to provide hospice care service for PLWH during EOL treatment.…”

Section: Discussionmentioning

confidence: 99%

Is there lower utilisation of hospice care services during end-of-life care for people living with HIV? A population-based cohort study

Chan

Lai

et al. 2022

BMJ Open

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ObjectiveHospice care could improve the quality of life among advanced HIV patients during end-of-life (EOL) treatment. However, providing hospice care services for people living with HIV (PLWH) is challenging due to HIV-related stigma. This nationwide cohort study aims to determine the utilisation of hospice care services among PLWH and HIV-negative individuals during EOL treatment.DesignA retrospective cohort study.SettingFrom 2000 to 2018, we identified adult PLWH from the Taiwan centres for disease control HIV Surveillance System. Individuals who had positive HIV-1 western blots were regarded as HIV-infected. Age-matched and sex-matched controls without HIV infection were selected from the Taiwan National Health Insurance Research Database for comparison. All PLWH and controls were followed until death or 31 December 2018.Participants32 647 PLWH and 326 470 HIV-negative controls were analysed.Primary outcome measuresUtilisation of hospice care services during the last year of life among PLWH and HIV-negative individuals.ResultsA total of 20 413 subjects died during the 3 434 699 person-years of follow-up. Of the deceased patients, 2139 (10.5%) utilised hospice care services during their last year of life, including 328 (5.76%) PLWH and 1811 (12.30%) controls. Adjusting for demographics and comorbidities, PLWH were less likely to receive hospice care services during the last year of life, compared with HIV-negative individuals (adjusted OR: 0.66; 95% CI: 0.57 to 0.75).ConclusionsPLWH had significantly lower utilisation of hospice care services during the last year of life. Our results suggest that future hospice care programmes should particularly target PLWH to increase the optimal utilisation of hospice care services during EOL treatment.

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“…Timely referral of patients with hepatic failure pertain to recent/recurrent hepatic severe decompensation and not being a candidate for liver transplant [41]. The human immunodeficiency virus (HIV) disease, despite much longer prognosis when properly treated, encompasses acquired immunodeficiency syndrome (AIDS), cases not responding to antiretroviral therapy and with the co-existence of malignancies or dementia [42].…”

Section: Prognosis-based Criteriamentioning

confidence: 99%

Medical referral criteria for palliative care in adults: a scoping review

Grądalski¹

2022

Polish Archives of Internal Medicine

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Palliative care is focused on the relief of serious suffering due to severe illness. The Polish health reimbursement system limits it to a "basket" of recipients with life-limiting incurable diseases (mainly cancer), not responding to disease-modifying therapy. This scoping literature review was aimed at establishing a definition for the criteria of medical referral with regard to "life-limiting illness" and "disease-modifying therapy", which may aid in increasing appropriate treatment and referrals. The PubMed and Google Scholar databases (2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020)(2021) were searched in the context of referral/eligibility/admission and end-stage/palliative care. Of 790 research articles, 103 studies met the inclusion criteria. Two groups of referral criteria were found: disease/prognosis-and needs-based. The first was concentrated on 6-12-month survival prognosis, the second encompassed the presence of severe/complex/persistent symptoms/problems not responding to optimal treatment. Numerous examples of diseasemodifying treatments within specific advanced diseases were found. The discriminants characterizing life-limited diseases in individual cases should be preferably used in clusters to accurately screen for eligibility. Equally important as limited prognosis is the presence of severe, complex, and persistent symptoms or problems occurring despite optimal treatment and general care. Based on the reviewed findings, national reimbursement coverage should be urgently extended to cover more patients who are eligible and could benefit from specialist palliative care. Additionally, general palliative care should be universally acknowledged.

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End-of-life care for HIV-infected patients with malignancies: A questionnaire-based survey

Abstract: Our findings suggest that in Japan, HIV patients with malignancies have difficulties obtaining hospitalization at a palliative care unit, which is likely due to a lack of experience among the professionals in treating such patients as well as a lack of knowledge about HIV.

Cited by 5 publications

References 27 publications

Disparities in mortality trends of adults with HIV in the USA: A comprehensive examination across 2 decades

Disparities in mortality trends of adults with HIV in the USA: A comprehensive examination across 2 decades

Is there lower utilisation of hospice care services during end-of-life care for people living with HIV? A population-based cohort study

Medical referral criteria for palliative care in adults: a scoping review

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