Clinician-Patient Care Planning is Critical to Determine Affordable HIV Treatment

An online survey found that people living with HIV who had lower incomes are at a higher risk for household material hardships and poorer health outcomes.

Research has already identified that social factors including financial status, food insecurity, and housing instability play a role in patient’s health and can also have an effect on adherence to necessary treatment.

An individual’s financial status can also be affected by out-of-pocket health costs and a lack of access to patient assistance resources, among others. Additionally, it can be difficult for providers to discuss financial hardships and address these issues once they are identified.

To improve provider screening, communication, and resource navigation to match the needs of their patients and clients, a team of investigators from the Patient Advocate Foundation, conducted a project to assess reasons for financial hardship. They presented their findings in a late-breaker presentation at the Association of Nurses in AIDS Care Conference (ANAC 2019).

For the research, the team conducted an online survey of 1385 patients with a variety of conditions. The respondents included 268 individuals living with HIV. The survey was designed to identify the source of financial toxicity, care affordability, and cost concerns, and assess unique challenges faced by people living with HIV.

The survey consisted of 51 questions which centered around sources of financial stress, affordability of treatment for the individual’s respective condition, out-of-pocket costs, financial toxicity and hardships along with experiences of shared decision-making.

Through the results of the survey, the authors of the abstract found that people living with HIV who had lower incomes are at a higher risk for household material hardships and poorer health outcomes. Additionally, this population was more likely to utilize health care resources.

Based on this finding, the authors assert that it is crucial for clinicians to consider social factors and financial status in conversations regarding treatment options. When treating an individual who is living with HIV it is key to design a treatment plan that is sustainable and one that a patient can both afford and adhere to.

“Managing the comprehensive costs associated with an HIV diagnosis or preventative medications will require a strategic approach,” the authors wrote. “[The] process should rely on clinician-patient care planning, cost information, cost conversations, and referrals to appropriate resources.”

Furthermore, it may be beneficial to connect patients to nonprofit navigation services which can provide access to resources that can reduce the burden of social and financial factors.

“By disseminating information about HIV patient cost concerns and strengthening relationships between nurses and nonprofit organizations that support patient linkage to services, the system can help ensure patients remain adherent and engaged in care,” the authors concluded.

The abstract, Identifying the Role of Nonprofit Patient Navigation Services in Assisting Nurses with Addressing Social Determinant of Health, was presented in a late breaker session on Friday, November 8, at ANAC 2019 in Portland, Oregon.