Positive Outcomes HIV: Difference between revisions
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* '''Relational''' - sexual health, family planning, intimacy | * '''Relational''' - sexual health, family planning, intimacy | ||
* '''Information needs''' - about managing HIV | * '''Information needs''' - about managing HIV | ||
== Development == | |||
Development of the Positive Outcomes HIV PROM involved a steering group , which included<ref name=":0" />: | |||
* Four people living with HIV - to ensure the patient is regarded as an expert in their condition | |||
* Four Health services researchers - to ensure that it would benefit service planning | |||
* Five HIV healthcare professionals - to ensure clinical relevance | |||
The stages of development were as follows<ref name=":0" />: | |||
# '''Stage 1:''' Gathering of information from key stakeholders through in-depth interviews to define concepts and generate items in a manner that ensures face and content validity. | |||
# '''Stage 2:''' Item generation in two phases, which lead to a prototype | |||
# '''Stage 3:''' Item improvement through cognitive interviewing | |||
== Method of Use == | == Method of Use == | ||
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** The first of these is a global assessment of wellbeing | ** The first of these is a global assessment of wellbeing | ||
** The remaining 21 ask about specific constructs within 6 domains of need | ** The remaining 21 ask about specific constructs within 6 domains of need | ||
The PROM helps to highlight areas for discussion and gives a score of 0-88. The higher the score, the higher the burden of concerns/symptoms<ref name=":0" />. | |||
The PROM helps to highlight areas for discussion and gives a score of 0-88. The higher the score, the higher the burden of concerns/symptoms<ref name=":0" />. | The PROM helps to highlight areas for discussion and gives a score of 0-88. The higher the score, the higher the burden of concerns/symptoms<ref name=":0" />. | ||
It can be used at various intervals to allow for monitoring and evaluation, as well as continued treatment approaches that are responsive the the changing needs of PLWH. | It can be used at various intervals to allow for monitoring and evaluation, as well as continued treatment approaches that are responsive the the changing needs of PLWH. | ||
== Evidence == | == Evidence == | ||
Revision as of 15:33, 28 May 2023
Original Editor - User Name
Top Contributors - Melissa Coetsee and Kim Jackson
Objective[edit | edit source]
The Positive Outcomes is a novel patient reported outcome measure (PROM) designed to reflect the multidimensional symptoms and concerns faced by people living with Human Immunodeficiency Virus (HIV)[1].
It was developed (in 2020) to provide a brief, yet comprehensive, means of measuring patient concerns in the clinical context (for day-to-day routine care), with the aim of improving outcomes by promoting person-centred care. The goal was for it to adequately reflect what matters most to PLWH, while being specific enough to guide healthcare providers and providing individualised care[1].
Prior to the Positive Outcomes, most available HIV PROMs were focused on single dimensions[1]. The Positive Outcomes aims to fill this gap by providing the first single tool that measures multiple dimensions in this population group.
Intended Population[edit | edit source]
Positive Outcomes is a disease specific outcome measure designed for people (adults) living with HIV (PLWH). PLWH face a complex combination of physical, social and psychological factors which can adversely affect their quality of life. Generic PROMs have not been sufficient in detecting all the symptoms and concerns associated with HIV (eg. stigma and treatment adherence). Accurate measurement of these factors in the clinical setting can facilitate more holistic management approaches for PLWH[1].
The domains included in the Positive Outcomes PROM are:
- Physical - pain, stomach and bowel, activities of daily living, sleep, memory or concentration
- Psychological - anxiety, depression, concerns around HIV disclosure, self esteem, spiritual needs
- Social - safety in relationships, recreational substance use, money, housing, immigration status, social support
- Relational - sexual health, family planning, intimacy
- Information needs - about managing HIV
Development[edit | edit source]
Development of the Positive Outcomes HIV PROM involved a steering group , which included[1]:
- Four people living with HIV - to ensure the patient is regarded as an expert in their condition
- Four Health services researchers - to ensure that it would benefit service planning
- Five HIV healthcare professionals - to ensure clinical relevance
The stages of development were as follows[1]:
- Stage 1: Gathering of information from key stakeholders through in-depth interviews to define concepts and generate items in a manner that ensures face and content validity.
- Stage 2: Item generation in two phases, which lead to a prototype
- Stage 3: Item improvement through cognitive interviewing
Method of Use[edit | edit source]
Patients as asked to complete a questionnaire prior to their contact with a healthcare provider. Clinicians then have to opportunity to focus the consultation according to the needs identified in the PROM.
Components of the PROM[1]:
- Opens with one open-ended question offering the individual the opportunity to report their three main priorities for focus within their HIV consultation
- 22 Questions with standard Likert (five point) response scales.
- The first of these is a global assessment of wellbeing
- The remaining 21 ask about specific constructs within 6 domains of need
The PROM helps to highlight areas for discussion and gives a score of 0-88. The higher the score, the higher the burden of concerns/symptoms[1].
The PROM helps to highlight areas for discussion and gives a score of 0-88. The higher the score, the higher the burden of concerns/symptoms[1].
It can be used at various intervals to allow for monitoring and evaluation, as well as continued treatment approaches that are responsive the the changing needs of PLWH.
Evidence[edit | edit source]
Reliability[edit | edit source]
Validity[edit | edit source]
Content Validity[edit | edit source]
The Positive Outcomes PROM has proven content validity as measured by the COSMIN criteria. This means that is there is evidence to support its relevance, comprehensiveness and comprehensibility [1]
Face Validity[edit | edit source]
Key stakeholders were engaged during the development of the PROM, which has ensured good face validity[1].
Responsiveness[edit | edit source]
The length (amount of questions) and recall period (max 4 weeks) were chosen based on feedback from HIV patients. Allowance is also made for a single open-ended question to provide patients with an opportunity to raise additional concerns[1].
A diverse group of PLWH were involved in item generation and testing, but a few ethnic groups were underrepresented (minority groups that do not classify as black African or Caribbean).
Conclusion[edit | edit source]
The Positive Outcomes HIV PROM is the first brief PROM designed for used in the clinical setting, which addresses all domains affecting PLWH. Incorporating it into routine HIV care will allow PLWH to communicate their priorities, and empower them to be active participants in their care[1]. It also provides a very useful tool to be used in research studies that are aimed at evaluating and measuring the effectiveness and comprehensiveness of HIV programs.
Links[edit | edit source]
References[edit | edit source]
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 Bristowe K, Murtagh FE, Clift P, James R, Josh J, Platt M, Whetham J, Nixon E, Post FA, McQuillan K, Cheallaigh CN. The development and cognitive testing of the positive outcomes HIV PROM: a brief novel patient-reported outcome measure for adults living with HIV. Health and Quality of Life Outcomes. 2020 Dec;18(1):1-0.
