CASA: Care and Support Access in HIV Disease
| Status: | Active, not recruiting |
|---|---|
| Conditions: | HIV / AIDS |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | 18 - 35 |
| Updated: | 2/28/2019 |
| Start Date: | July 2014 |
| End Date: | March 31, 2019 |
CASA: Care and Support Access Study for Implementation of a Palliative Approach With HIV Treatment
This is an investigator-initiated study to measure the impact of an educational intervention
on the basic palliative approach for a multidisciplinary staff team at an outpatient HIV
clinic. The study aims to: 1) refine a curriculum for non-palliative care clinicians caring
for persons living with HIV disease early in the disease trajectory; 2) assess the impact of
the palliative approach educational intervention on outcomes for 2 target populations: a)
patients (mental health, quality of life, health-related quality of life and secondarily,
retention in care and viral suppression) and b) staff (burn-out and caregiving stress). It is
hypothesized that training outpatient HIV staff in palliative care competencies will improve
care provided that might, in turn, improve clinical outcomes for HIV patients receiving care
at that clinic. Quantitative data will be augmented by qualitative interviews of selected
staff and patients at both clinics in the final year of the study to appreciate response to
the intervention.
on the basic palliative approach for a multidisciplinary staff team at an outpatient HIV
clinic. The study aims to: 1) refine a curriculum for non-palliative care clinicians caring
for persons living with HIV disease early in the disease trajectory; 2) assess the impact of
the palliative approach educational intervention on outcomes for 2 target populations: a)
patients (mental health, quality of life, health-related quality of life and secondarily,
retention in care and viral suppression) and b) staff (burn-out and caregiving stress). It is
hypothesized that training outpatient HIV staff in palliative care competencies will improve
care provided that might, in turn, improve clinical outcomes for HIV patients receiving care
at that clinic. Quantitative data will be augmented by qualitative interviews of selected
staff and patients at both clinics in the final year of the study to appreciate response to
the intervention.
Evidence exists in African populations that palliative care delivered early in the HIV
disease trajectory can improve symptom management and mental health. This study represents a
proof of principle for HIV care delivery in the US using observed distillation of critical
palliative elements.
Care and Support Access (CASA) is a complex multidisciplinary care strategy in which a
palliative approach is integrated into the delivery of standard HIV care, using an iterative
teaching method and on-site mentored training of site-based care teams. CASA will implement
patient-centeredness into HIV treatment at the practice setting to improve patient-level
outcomes for persons with HIV/AIDS known to have difficulty in engaging in care, initiating
antiretroviral therapy (ART), and remaining in routine follow-up. This lack of retention puts
them at high risk for experiencing health-related symptoms and poor quality of life (QOL).
The study design is quasi-experimental with longitudinal observation of the HIV positive
young men who have sex with men (yMSM) population and staff who deliver their care at two HIV
outpatient clinics. We use mixed methods (surveys and qualitative interviews) with the
patients and staff at both clinics.
The Specific Aims are:
(1) To refine, deliver and determine the acceptability and applicability of an
interdisciplinary professional education program for a site-based multidisciplinary health
care team on the integration of basic palliative care domains fundamental to patient-centered
care with standard HIV care.
2) To obtain insights regarding the CASA experience and to describe and measure the impact of
early integration of a palliative approach upon yMSM relative to: a) improvement of mental
health status, health-related quality of life and overall quality of life; b) increased
retention in care and viral suppression.
3) To describe and measure the impact upon staff of the early integration of the palliative
approach with regard to: a) reducing work-related stress; and b) burn-out.
The anticipated impact of the CASA study will be to improve clinical practice with regard to
engagement and retention of difficult to engage and retain patient populations by introducing
a basic palliative approach to care management.
disease trajectory can improve symptom management and mental health. This study represents a
proof of principle for HIV care delivery in the US using observed distillation of critical
palliative elements.
Care and Support Access (CASA) is a complex multidisciplinary care strategy in which a
palliative approach is integrated into the delivery of standard HIV care, using an iterative
teaching method and on-site mentored training of site-based care teams. CASA will implement
patient-centeredness into HIV treatment at the practice setting to improve patient-level
outcomes for persons with HIV/AIDS known to have difficulty in engaging in care, initiating
antiretroviral therapy (ART), and remaining in routine follow-up. This lack of retention puts
them at high risk for experiencing health-related symptoms and poor quality of life (QOL).
The study design is quasi-experimental with longitudinal observation of the HIV positive
young men who have sex with men (yMSM) population and staff who deliver their care at two HIV
outpatient clinics. We use mixed methods (surveys and qualitative interviews) with the
patients and staff at both clinics.
The Specific Aims are:
(1) To refine, deliver and determine the acceptability and applicability of an
interdisciplinary professional education program for a site-based multidisciplinary health
care team on the integration of basic palliative care domains fundamental to patient-centered
care with standard HIV care.
2) To obtain insights regarding the CASA experience and to describe and measure the impact of
early integration of a palliative approach upon yMSM relative to: a) improvement of mental
health status, health-related quality of life and overall quality of life; b) increased
retention in care and viral suppression.
3) To describe and measure the impact upon staff of the early integration of the palliative
approach with regard to: a) reducing work-related stress; and b) burn-out.
The anticipated impact of the CASA study will be to improve clinical practice with regard to
engagement and retention of difficult to engage and retain patient populations by introducing
a basic palliative approach to care management.
PATIENTS -
Inclusion Criteria:
- HIV positive
- men who have sex with men attending one of 2 study site clinics
- 18-35 years
Exclusion Criteria:
- acute illness requiring medical attention
- cognitive impairment
We found this trial at
1
site
Baltimore, Maryland 21201
Principal Investigator: Carla S Alexander, MD
Phone: 410-328-7129
Click here to add this to my saved trials
