Advice to community physicians regarding ways to enhance patient-provider relationships and navigate barriers that impact the management of HIV infections.
Frank J. Palella, MD: The optimization of the clinician-patient relationship requires several key components: trust, and for that trust to exist, clinicians need to provide an environment in which their patients feel comfortable disclosing concerns, issues, and challenges. These include issues regarding barriers to adherence, lapses in taking medication, disclosures of scenarios such as addiction, sexual activity, and smoking, and disclosing aspects of social determinants of health like housing or food insecurity, or abuse situations.
Patients need to feel comfortable telling their providers anything about their lives that can impact their health, depression and anxiety included, and feel confident that their providers would listen, be attentive, acknowledge and adjust the approach to health care to optimize those factors to the best extent possible. It does take a team. Often, it’s not merely just the prescribing provider and the patient. It’s nursing, social work or case management, phlebotomists, and other individuals in the health care delivery team. It does take a village when it comes to this approach. The overall goal has been and remains to optimize health, extend the health span and life span, and optimize the likelihood that success can be achieved and maintained—not merely in terms of virologic suppression but in terms of overall maintenance of health and well-being, and retention and care.
In terms of advice for the HIV-treating community, keep doing what you’re doing, listen to your patients, and be aware of new developments that could impact or nuance the management of the care that you deliver. This includes not just new therapies but new information regarding the impact of weight gain in cardiometabolic conditions. Undertake the best that you can the assessments that will help you modify treatment in a way that’s most supportive and encouraging of continued success in terms of effectiveness, adherence, and tolerability of therapy delivery.
Transcript edited for clarity.