Pilot Study to Evaluate the Decentralization of Patient Care Among People With HIV in Out-of-hospital Settings (OOH)
The goal of this 24-week, open-label, randomized pilot study is to assess the feasibility and impact of decentralized HIV care in a community setting (BCN Checkpoint), focusing on patient satisfaction and experience and carbon footprint.
The main question it aims to answer is patients' satisfaction with the medical care at week 24, derived from decentralizing the patient care compared to continuing with the usual follow-up at the hospital.
Participants will attend a medical follow-up visit at week 24, an analytical test visit at week 24, and collect ARV every 8 weeks, at the center assigned during randomization (Hospital or BCN Checkpoint); as well as to fill a series of questionnaires at baseline and week 24.
Studieoversigt
Status
Detaljeret beskrivelse
The OOH (Out-Of-Hospital) study is a 24-week, open-label, randomized pilot study assessing the feasibility and impact of decentralized HIV care in a community setting (BCN Checkpoint), focusing on patient satisfaction and experience and carbon footprint.
Participants are randomized 2:1 to receive medical care and pick up ART at the BCN Checkpoint community centre (OOH Group) or at the Hospital (Hospital Group). Medical care encompass medical follow-up visits, collection of ART medication, vaccinations and analytical tests. Those who are randomized to the OOH Group are attended by the same physician they had at the hospital, and ART is collected every two months through self-automated lockers. Those who are randomized to the Hospital Group are attended as usual, at the hospital, and ART is collected every two months at the pharmacy service from the hospital.
For both Groups, study visits are scheduled at baseline, week 8, week 16, and week 24. The baseline visit includes medical evaluation and randomization; visits at weeks 8 and 16 consist exclusively of ART collection, while the week 24 visit includes ART collection, a medical consultation, and blood testing. After the 24-week study period, all participants have the option to switch their medical care to the other centre.
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
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Barcelona
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Badalona, Barcelona, Spanien, 08916
- Hospital Universitario Germans Trias i Pujol
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
Stable ARV treatment for ≥6 months with oral medications including:
- Biktarvy (bictegravir/emtricitabina/tenofovir alafenamida)
- Dovato (dolutegravir/lamivudina)
- Juluca (dolutegravir/rilpivirina)
- dolutegravir + emtricitabina/tenofovir
- Symtuza (darunavir/cobicistat/emtricitabina/tenofovir alafenamida)
- Undetectable HIV viral load for ≥6 months.
- Good treatment adherence according to the HIV and pharmacy teams.
- Good adherence to medical appointments
- Using a mobile app and acceptance of the established process.
- Signed Informed Consent.
Exclusion Criteria:
- Acute disease or decompensated chronic diseases in the last 6 months.
- Any other condition that advises against out-of-hospital follow-up.
- Participants who are already using the locker system to pick up their medication.
- Pregnant Women
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Andet
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Ingen indgriben: Medical care at the Hospital
Includes medical follow-up visits, collection of ARV and analytical tests, as per usual rutinary practice, in Hospital.
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Eksperimentel: Medical care at Out-of-Hospital community center
Evaluates the benefits of implementing the decentralization of patient care into communitary facilities such as BCN Checkpoint/BCN Prep·Point.
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Decentralization of medical care includes: medical follow-up visits, collection of ARV and analytical tests.
As per usual rutinary practice, medication will be collected every two months at both facilities.
The study will have a duration of 24 weeks.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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To evaluate and compare the benefits in terms of patients' satisfaction derived from decentralizing the patient care versus continuing with the usual follow-up.
Tidsramme: week 24
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Compare between groups the percentage of patients who, in the item No. 8 of the patients' expectations and satisfaction questionnaire self-developed ad hoc for this study, have indicated ≥ 8 points of satisfaction at week 24.
This item consists of a 10-point scale were 10 is the maximum expression of satisfaction and 1 is the lowest rank.
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week 24
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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To evaluate and compare patients' expectations regarding a positive impact of decentralizing the patient care in the following areas: treatment adherence, visits follow-up, disease perception, physical and emotional QoL, family and social relationships
Tidsramme: week 24
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Compare between groups the median of the obtained scores from items 1 to 7 in a patients' expectations and satisfaction questionnaire self-developed ad hoc for this study at week 24.
Items 1 to 7 of the questionnaire consist of a 5-point likert scale were 1 corresponds to "completely disagree" and 5 corresponds to "completely agree".
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week 24
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To evaluate and compare patients' quality of life
Tidsramme: week 24
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Compare between groups the percentage of participants who report a very good or good quality of life, obtaining a score between 1 or 2 on the Medical Outcomes study HIV Health Survey (MOS-HIV) scale at week 24.
MOS-HIV quality of life and transitory health items were quantified separately, and the score ranged from 1 (best) to 5 (worse).
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week 24
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To evaluate and compare patients' perception of illness severity.
Tidsramme: week 24
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Compare between groups the percentage of patients with moderate illness severity perception (Score 42 to 49) and patients with severe illness severity perception (score ≥ 50) using the 8-item Brief Illness Perception Questionnaire, were each item consists of a 10-point scale ranging from 0 (no influence) to 10 (major influence).
Additionally, among illness perception criteria, Cognitive Representation is obtained from the sum of items 1-5; the Emotional Representation is obtained from the sum of items 6 and 8; and the item 7 corresponds to the Disease Understanding dimension.
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week 24
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To evaluate and compare expectations and satisfaction among health staff (a nurse and a physician) regarding the positive impact of decentralizing the patient care.
Tidsramme: week 24
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Compare changes at week 24 in the median of the obtained scores from all items in the health staff's expectations and satisfaction questionnaire self-developed ad hoc for this study at week 24.
Items 1 to 7 of the questionnaire consist of a 5-point likert scale were 1 corresponds to "completely disagree" and 5 corresponds to "completely agree".
item No. 8 consists of a 10-point scale were 10 is the maximum expression of satisfaction and 1 is the lowest rank.
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week 24
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Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Distance to care facility (out-of-hospital facility or hospital)
Tidsramme: 24 weeks
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To assess and compare the two-way total transportation distance (in km) to out-of-hospital facility and to the hospital at week 24 for a total of 3 study visits in the study period.
Distance data from a single transfer is requested at the baseline visit.
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24 weeks
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Time to care facility (out-of-hospital facility or hospital)
Tidsramme: 24 weeks
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To assess and compare the two-way total transportation time (in minutes) to the out-of-hospital facility and to the hospital at week 24 for a total of 3 study visits in the study period.
Time data from a single transfer is requested at the baseline visit.
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24 weeks
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Carbon footprint associated with healthcare visits
Tidsramme: week 24
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Comparison of the estimated carbon footprint (in gCO2) generated by healthcare visits up to Week 24 between participants attending the out-of-hospital facility and those attending the hospital at week 24 for a total of 3 study visits in the study period.
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week 24
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Samarbejdspartnere og efterforskere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Andre undersøgelses-id-numre
- OOH Study
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
The raw and individual personal data are protected and not available to anyone due to applicable data privacy legislation: The processing of the data are subjected to current legislation as regards data protection (LOPD, The Organic Law 3/2018 of 5 December on the Protection of Personal Data and the Guarantee of Digital Rights complementary to the Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016, on the protection of natural persons with regard to the processing of personal data and on the free movement of such data).
The raw dataset that supports the findings of this study are available from Fundació FLS de Lluita contra la Sida, les Malalties Infeccioses i la Promoció de la Salut i La Ciència but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Raw datasets results are however available for other researchers from the authors upon reasonable request.
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