Organisation and integrated healthcare approaches for people living with HIV, multimorbidity, or both

Detalhes bibliográficos
Autor(a) principal: Nicolau, Vanessa
Data de Publicação: 2023
Outros Autores: Brandão, Daniela, Rua, Tiago, Escoval, Ana
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/157561
Resumo: Funding Information: The systematic review was conducted as part of the project “Financiamento do VIH no continuum do percurso da pessoa com doença” [HIV financing in the continuum of the care path of the person with disease”] funded by the Gilead Sciences, Inc. The present publication was funded by Fundação Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020). Publisher Copyright: © 2023, BioMed Central Ltd., part of Springer Nature.
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spelling Organisation and integrated healthcare approaches for people living with HIV, multimorbidity, or botha systematic reviewCare coordinationChange managementContinuity of careCoproductionHIV infectionIntegrated careLearning health systemsMultimorbidityPeople-centred careSelf-managementPublic Health, Environmental and Occupational HealthSDG 3 - Good Health and Well-beingFunding Information: The systematic review was conducted as part of the project “Financiamento do VIH no continuum do percurso da pessoa com doença” [HIV financing in the continuum of the care path of the person with disease”] funded by the Gilead Sciences, Inc. The present publication was funded by Fundação Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020). Publisher Copyright: © 2023, BioMed Central Ltd., part of Springer Nature.Background: Universal recommendation for antiretroviral drugs and their effectiveness has put forward the challenge of assuring a chronic and continued care approach to PLHIV (People Living with HIV), pressured by aging and multimorbidity. Integrated approaches are emerging which are more responsive to that reality. Studying those approaches, and their relation to the what of delivery arrangements and the how of implementation processes, may support future strategies to attain more effective organizational responses. Methods: We reviewed empirical studies on either HIV, multimorbidity, or both. The studies were published between 2011 and 2020, describing integrated approaches, their design, implementation, and evaluation strategy. Quantitative, qualitative, or mixed methods were included. Electronic databases reviewed cover PubMed, SCOPUS, and Web of Science. A narrative analysis was conducted on each study, and data extraction was accomplished according to the Effective Practice and Organisation of Care taxonomy of health systems interventions. Results: A total of 30 studies, reporting 22 different interventions, were analysed. In general, interventions were grounded and guided by models and frameworks, and focused on specific subpopulations, or priority groups at increased risk of poorer outcomes. Interventions mixed multiple integrated components. Delivery arrangements targeted more frequently clinical integration (n = 13), and care in proximity, community or online-telephone based (n = 15). Interventions reported investments in the role of users, through self-management support (n = 16), and in coordination, through multidisciplinary teams (n = 9) and continuity of care (n = 8). Implementation strategies targeted educational and training activities (n = 12), and less often, mechanisms of iterative improvement (n = 3). At the level of organizational design and governance, interventions mobilised users and communities through representation, at boards and committees, and through consultancy, along different phases of the design process (n = 11). Conclusion: The data advance important lessons and considerations to take steps forward from disease-focused care to integrated care at two critical levels: design and implementation. Multidisciplinary work, continuity of care, and meaningful engagement of users seem crucial to attain care that is comprehensive and more proximal, within or cross organizations, or sectors. Promising practices are advanced at the level of design, implementation, and evaluation, that set integration as a continued process of improvement and value professionals and users’ knowledge as assets along those phases. Trial registration: PROSPERO number CRD42020194117.Centro de Investigação em Saúde Pública (CISP/PHRC)Comprehensive Health Research Centre (CHRC) - Pólo ENSPEscola Nacional de Saúde Pública (ENSP)RUNNicolau, VanessaBrandão, DanielaRua, TiagoEscoval, Ana2023-09-08T22:14:16Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/157561eng1471-2458PURE: 71183590https://doi.org/10.1186/s12889-023-16485-yinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:39:54Zoai:run.unl.pt:10362/157561Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:56:47.463815Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Organisation and integrated healthcare approaches for people living with HIV, multimorbidity, or both
a systematic review
title Organisation and integrated healthcare approaches for people living with HIV, multimorbidity, or both
spellingShingle Organisation and integrated healthcare approaches for people living with HIV, multimorbidity, or both
Nicolau, Vanessa
Care coordination
Change management
Continuity of care
Coproduction
HIV infection
Integrated care
Learning health systems
Multimorbidity
People-centred care
Self-management
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
title_short Organisation and integrated healthcare approaches for people living with HIV, multimorbidity, or both
title_full Organisation and integrated healthcare approaches for people living with HIV, multimorbidity, or both
title_fullStr Organisation and integrated healthcare approaches for people living with HIV, multimorbidity, or both
title_full_unstemmed Organisation and integrated healthcare approaches for people living with HIV, multimorbidity, or both
title_sort Organisation and integrated healthcare approaches for people living with HIV, multimorbidity, or both
author Nicolau, Vanessa
author_facet Nicolau, Vanessa
Brandão, Daniela
Rua, Tiago
Escoval, Ana
author_role author
author2 Brandão, Daniela
Rua, Tiago
Escoval, Ana
author2_role author
author
author
dc.contributor.none.fl_str_mv Centro de Investigação em Saúde Pública (CISP/PHRC)
Comprehensive Health Research Centre (CHRC) - Pólo ENSP
Escola Nacional de Saúde Pública (ENSP)
RUN
dc.contributor.author.fl_str_mv Nicolau, Vanessa
Brandão, Daniela
Rua, Tiago
Escoval, Ana
dc.subject.por.fl_str_mv Care coordination
Change management
Continuity of care
Coproduction
HIV infection
Integrated care
Learning health systems
Multimorbidity
People-centred care
Self-management
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
topic Care coordination
Change management
Continuity of care
Coproduction
HIV infection
Integrated care
Learning health systems
Multimorbidity
People-centred care
Self-management
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
description Funding Information: The systematic review was conducted as part of the project “Financiamento do VIH no continuum do percurso da pessoa com doença” [HIV financing in the continuum of the care path of the person with disease”] funded by the Gilead Sciences, Inc. The present publication was funded by Fundação Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020). Publisher Copyright: © 2023, BioMed Central Ltd., part of Springer Nature.
publishDate 2023
dc.date.none.fl_str_mv 2023-09-08T22:14:16Z
2023
2023-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/157561
url http://hdl.handle.net/10362/157561
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1471-2458
PURE: 71183590
https://doi.org/10.1186/s12889-023-16485-y
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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