Improving HIV Treatment Decisions through an Interprofessional Care Model

Background:

HIV medication regimen selection is historically the core of HIV treatment, yet there are critical gaps in first- and second-line HIV therapeutic management. These include 1) a lack of knowledge on the part of some clinicians regarding evolving HIV therapies and new clinical trial data, 2) clinicians' inconsistent use of HIV treatment guidelines, 3) inconsistent assessment, diagnosis and treatment of HIV patients, 4) clinicians' lack of experience managing chronic/co-morbid HIV treatment options, and 5) poor provider-patient communication negatively affecting patient adherence to treatment regimens.

Methods:

An innovative learning model educates clinicians on clinical decision pathways and interprofessional information sharing to optimize treatment decisions. Through in-person and online education seminars, the learning model takes clinicians through steps for determining appropriate therapies for individualizing therapeutic management for HIV treatment naïve and treatment experienced patients.

Results:

Evaluation data illustrate five primary achievement areas centering on reducing clinical HIV practice gaps and adherence to recommended standards of care for first- and second-line HIV therapies. These indicators highlight four aspects of the educational interventions: (1) participation consistency in each intervention (e.g., live meetings, online activities), (2) participant satisfaction with the program format and content delivery process, (3) educational content recall, and (4) clinical performance (behavioral) changes.

Conclusions:

Reducing gaps in HIV treatment decisions requires refined clinical decision pathways and an interprofessional approach to primary care. A multi-stage, multi-format approach to clinician learning provides peer comparisons of treatment decisions to identify common gaps and ensure performance improvement beyond the short-term.