Symptom Burden in HIV-Infected Adults at Time of HIV Diagnosis in Rural Uganda

Wakeham, Katie; Harding, Richard; Bamukama-Namakoola, Doreen; Levin, Jonathan; Kissa, John; Parkes-Ratanshi, Rosalind; Muzaaya, Godfrey; Grosskurth, Heiner; Lalloo, David G.

doi:10.1089/jpm.2009.0259

Cited by 56 publications

(57 citation statements)

References 34 publications

(34 reference statements)

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“…[9][10][11][12][13][14][15][16][17]37 It is clear from prior data that pain is a considerable burden on HIV-positive, cancer, and end-stage patients. This study now establishes that hospitalized patients also carry a significant amount of pain.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Beyond actively dying patients and those with fatal malignancies, patients with chronic conditions also experience untreated pain-studies have found the prevalence of pain to be 59% to 98% among HIV/AIDS patients in South Africa, Uganda, and Kenya. [14][15][16][17] Research on the correlates of pain in SSA has found that in HIV patients, pain has been associated with increasing age, female gender, not being on antiretroviral therapy, number of symptoms, advanced disease, number of medical comorbidities, and reduced functional performance scores. [18][19][20] These studies are specific to ambulatory HIV/AIDS patients, and to date no research has been conducted to determine the burden of pain in a mixed inpatient hospital setting in SSA.…”

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confidence: 99%

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Prevalence and Correlates of Pain and Pain Treatment in a Western Kenya Referral Hospital

Huang

Owino

Gramelspacher

et al. 2013

Journal of Palliative Medicine

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Background: Pain is often inadequately evaluated and treated in sub-Saharan Africa (SSA). Objective: We sought to assess pain levels and pain treatment in 400 hospitalized patients at a national referral hospital in western Kenya, and to identify factors associated with pain and pain treatment. Design: Using face-validated Kiswahili versions of two single-item pain assessment tools, the Numerical Rating Scale (NRS) and the Faces Pain Scale-Revised (FPS-R), we determined patients' pain levels. Additional data collected included patient demographics, prescribed analgesics, and administered analgesics. We calculated mean pain ratings and pain management index (PMI) scores. Results: Averaged between the NRS and FPS-R, 80.5% of patients endorsed a nonzero level of pain and 30% of patients reported moderate to severe pain. Older patients, patients with HIV, and cancer patients had higher pain ratings. Sixty-six percent of patients had been prescribed analgesics at some point during their hospitalization, the majority of which were nonopioids. A majority of patients (66%) had undertreated pain (negative scores on the PMI). Conclusion: This study shows that hospitalized patients in Kenya are experiencing pain and that this pain is often undertreated.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Prevalence and Correlates of Pain and Pain Treatment in a Western Kenya Referral Hospital

Huang

Owino

Gramelspacher

et al. 2013

Journal of Palliative Medicine

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“…While instruments like the Memorial Symptom Assessment Scale have been used to assess symptoms in patients with heart failure (68-70), COPD (71,72), and HIV disease (11,73), the most valid and reliable instrument to assess symptoms for symptom cluster research across a variety of chronic conditions is yet to be developed.…”

Section: Transferability To Other Chronic Conditionsmentioning

confidence: 99%

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Miaskowski

Barsevick

Berger

et al. 2017

JNCI J Natl Cancer Inst

328

330

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An overview of proceedings, findings, and recommendations from the workshop on "Advancing Symptom Science Through Symptom Cluster Research" sponsored by the National Institute of Nursing Research (NINR) and the Office of Rare Diseases Research, National Center for Advancing Translational Sciences, is presented. This workshop engaged an expert panel in an evidenced-based discussion regarding the state of the science of symptom clusters in chronic conditions including cancer and other rare diseases. An interdisciplinary working group from the extramural research community representing nursing, medicine, oncology, psychology, and bioinformatics was convened at the National Institutes of Health. Based on expertise, members were divided into teams to address key areas: defining characteristics of symptom clusters, priority symptom clusters and underlying mechanisms, measurement issues, targeted interventions, and new analytic strategies. For each area, the evidence was synthesized, limitations and gaps identified, and recommendations for future research delineated. The majority of findings in each area were from studies of oncology patients. However, increasing evidence suggests that symptom clusters occur in patients with other chronic conditions (eg, pulmonary, cardiac, and end-stage renal disease). Nonetheless, symptom cluster research is extremely limited and scientists are just beginning to understand how to investigate symptom clusters by developing frameworks and new methods and approaches. With a focus on personalized care, an understanding of individual susceptibility to symptoms and whether a "driving" symptom exists that triggers other symptoms in the cluster is needed. Also, research aimed at identifying the mechanisms that underlie symptom clusters is essential to developing targeted interventions.Patients with chronic conditions, such as cancer and other rare diseases, experience an array of multiple co-occurring symptoms (eg, pain, fatigue, sleep disturbance). When these symptoms remain underdiagnosed and undertreated, they have a negative impact on patient-reported outcomes (PROs) including functional performance, cognitive status, and quality of life (QOL). A reduction in symptom burden in these patients has the potential to improve their capacity to live well over their entire lives. To achieve this goal, a transformation is needed in how multiple co-occurring symptoms are assessed and managed in order to improve patient outcomes and stimulate a reduction in health care utilization and costs. A strategic plan that advances REVIEW

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“…9,47 The MSAS-SF has been widely used in describing symptom experience in HIV/AIDS patients and in African settings. 63,66 Each physical symptom experienced by the patient was scored for the level of distress it caused on a 5-point (ie, 0 to 4) Likert scale (ie, ''not at all,'' ''a little bit,'' ''somewhat,'' ''quite a bit,'' and ''very much''). The burden of psychological symptoms was scored on a scale of 0 to 4 (corresponding to ''not at all,'' ''rarely,'' ''occasionally,'' ''frequently,'' and ''almost constantly'').…”

Section: Memorial Symptom Assessment Scale-short Form (Msas-sf)mentioning

confidence: 99%

“…61 A high prevalence of burdensome physical and psychological symptoms has been reported at all stages of HIV infection. 26,53,62,64,66 Pain is also experienced throughout the HIV disease trajectory, with severe pain experienced by 80 to 98% of those with advanced HIV. 4,43,57 Recent studies show that antiretroviral therapy (ART) has not eliminated the need for effective pain and symptom control, given that problems (sometimes treatment related) persist.…”

mentioning

confidence: 99%

Pain Among Ambulatory HIV/AIDS Patients: Multicenter Study of Prevalence, Intensity, Associated Factors, and Effect

Namisango

Harding

Atuhaire

et al. 2012

The Journal of Pain

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Symptom Burden in HIV-Infected Adults at Time of HIV Diagnosis in Rural Uganda

Abstract: This study demonstrates that the burden of HIV-related symptoms in individuals presenting for care in Uganda is significant and debilitating.

Cited by 56 publications

References 34 publications

Prevalence and Correlates of Pain and Pain Treatment in a Western Kenya Referral Hospital

Prevalence and Correlates of Pain and Pain Treatment in a Western Kenya Referral Hospital

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Pain Among Ambulatory HIV/AIDS Patients: Multicenter Study of Prevalence, Intensity, Associated Factors, and Effect

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