Special Article
Integrating Palliative Care Into HIV Outpatient Clinical Settings: Preliminary Findings From an Intervention Study in Vietnam

https://doi.org/10.1016/j.jpainsymman.2010.04.006Get rights and content
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Abstract

Symptom assessment and treatment for people living with HIV (PLHIV) cannot only lead to improvements in quality of life but contribute to combination antiretroviral adherence and early detection of virologic rebound. The majority of PLHIV in Vietnam receive their care in HIV outpatient settings, whereas very few clinics provide palliative care. The Ministry of Health has called for palliative care to be incorporated into existing HIV and cancer services, but there is limited guidance regarding how to operationalize integration. An HIV outpatient clinic palliative care intervention was tested in northern Vietnam to explore the accessibility, acceptability, and feasibility of integrated services. Primary outcome measures included changes in identification and treatment of pain and other symptoms, the prevalence of depression and anxiety, and perceived social support. The palliative care intervention included introduction of tools and mentoring to assess and treat pain and other symptoms as well as mental health and social support screening, counseling, and treatment services. The intervention resulted in significant changes in provider practice and service delivery. Providers and patients reported overall satisfaction with the intervention and resulting improvements in quality of care.

Key Words

Palliative care
HIV
mental health
Vietnam
developing country
integration
evaluation

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This work was supported by United States Agency for International Development (USAID) agreement number 486-A-00-00009-00 through Family Health International (FHI). Its contents are the responsibility of the authors and do not necessarily represent the views of USAID or FHI.