AEGiS-11IAC: Prospective audit of eight HIV/AIDS community palliative care services.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Prospective audit of eight HIV/AIDS community palliative care services.

Int Conf AIDS 1996 Jul 7-12; 11:223 (abstract no. Th.B.190)
Butters E, Webb D, Hearn J, Higginson I; Health Services Research Unit, London School of Hygiene, London, UK. Fax: (+171) 580-8183 E-mail: E.Butters@LSHTM.ac.uk.

OBJECTIVES: To compare the process and outcomes of care provided by HIV/AIDS clinical nurse specialists (CNSs) and a multi-disciplinary palliative care team.

METHODS: Prospective clinical audit of consecutive referrals to all services for between 6 to 16 months. The Support Team Assessment Schedule (STAS) was the main outcome measure. Team members and CNSs assessed patients at referral and then at regular intervals until discharge or death.

RESULTS: In total 363 patients were referred. Three services cared for 82% of patients. Most (85%) patients were male, mean age 36.9 years (range 1-69), 63% were single, 49% lived alone and 23% had no career. At referral: 64% had an AIDS diagnosis and 25% a Karnofsky of 50 or less, 58% were at home and 38% in hospital. Most common reasons for referral were: symptom control (29%) and support patients (16%). In total 94 patients died in care, two services cared for 77% of these, 35% died at home, 44% in hospital and 21% in a hospice. Median time from referral to death was 14.4 weeks (range 1.4-112.5 weeks). STAS assessments identified family anxiety, patient anxiety and symptom control as the most commonly severe problems at referral, death and throughout care.

CONCLUSIONS: There were significant differences between services, especially in stage of disease at referral and their role. All services, except the team, spent less than a third of their time (20-30%) providing direct patient care. Two services cared for a small number of patients (5-11) and spent 40-43% of their time providing education and training to other professionals. Services with a largely advisory role found the recording of process and outcome data difficult.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Palliative Care, HIV Infections, Hospices, Death, Referral and Consultation, Outcome Assessment (Health Care), Caregivers, Family, Nurse Clinicians, Male, Human, ICA11

960707
ThB190