Marseille 2007
| Abstract #222 - The prevalence, burden and correlates of physical and psychological symptoms in HIV outpatient clinics | ||||
|
Session: 31.2: Quality of Life (Parallel) on Tuesday @ 11.00-12.30 in HC Chaired by Adinani Amidu, Wendee Wechsberg Authors: Presenting Author: Mr Richard Harding - Kings College, United Kingdom |
||||
| Additional Authors: Dr Lorraine Sherr, Ms Sally Norwood, Dr Fiona Lampe, | ||||
| Aim: The prevalence and burden of multidimensional symptoms have not been measured in the treatment era. The relationship of symptom burden to other key variables such as adherence, and sexual risk taking, have not been examined. | ||||
| Method / Issue: A cross sectional self complete survey of consecutive patients attending 5 outpatient clinics in London and South-East UK. Measures included the MSAS-SF symptom assessment schedule. Multiple regressions models were run with dependent variables of: model 1: physical distress index and model 2: psychological distress index. Independent variables were entered into multiple model if univariate significance was found at 25% level. | ||||
| Results / Comments: 778 patients participated (response rate 77% of those approached). The 10 most common symptoms were: lack of energy (70.8%), worry (69.9%), feeling drowsy (67.5%), sadness (66.3%), difficulty sleeping (61.8%), difficulty concentrating (60.7%), irritability (56.6%), diarrhoea (53.6%), sexual dysfunction (53.5%), pain (53.2%), with a mean of 17.86 symptoms present (SD=12.1). The physical symptom burden index (0.81), psychological burden index (1.34) and global burden index (1.16) of the MSAS-SF were found to be within the range of patients with advanced malignant disease reported in the literature. In multivariate models, whilst being on treatment was associated with improved psychological burden (b=-0.12, p=0.03), it had no effect on physical symptom burden. Both poorer adherence (b=0.14, p=0.002) and experiencing unprotected sex (b=0.08, p=0.06), were associated with increasing psychological symptom burden. | ||||
| Discussion: It is clear that in the era of treatments that effectively manage viral replication, patients live with a high prevalence and burden of distressing symptoms, both physical and psychological. It is essential that these problems are routinely assessed in order to gain maximum potential of the clinical effectiveness of treatments, both by improving patient quality of life and enhancing adherence to treatment. In addition, effective prevention strategies for prevention with positive people must take account of their psychological symptom burden. | ||||
| Go Back | ||||
