Naslov
EmERGE: feasibility and uptake of a co-designed digital health supported pathway of care for people living with medically stable HIV

Autori
Whetham, J ; Jones, C ; Bremner, S ; Apers, L ; Begovac, Josip ; Borges, M ; Leon, A ; Vera, J ; Zekan, Šime ; West, B ; Chausa, P ; Gomez, E ; Garcia, F ; EmERGE

Kolaboracija
EmERGE Consortium

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
HIV Glasgow

Mjesto i datum
Online, 05.10.2022. - 08.10.2022

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
EmERGE ; digital health ; HIV

Sažetak
Background: New digital approaches to clinical management of HIV have potential to manage capacity whilst maintaining excellent clinical outcomes. This study examined the feasibility and uptake of a digital care pathway for people living with medically stable HIV at five clinical sites in Europe. Materials and methods: The EmERGE platform (Figure 1) was codesigned, developed and integrated into the IT systems at the five sites. Participants were seen once a year by their clinician with interim results checked, encrypted and pushed through to an app on their mobile phone. A pre- post study design was used with clinical and questionnaire data collected including: viral load outcomes ; serious adverse events (SAEs) ; patient activation [PAM-13] ; adherence [M-MASRI] ; quality of life [EQ-5D-5L ; PROQOL-HIV] ; system usability score [SUS] and patient experience at baseline [M0], 12 [M12] and 24 months [M24]. Changes over time were estimated using mixed effects regression models. Results: The GDPR- compliant EmERGE platform was successfully integrated at all sites during 2017. Two thousand, two hundred and fifty-one participants (mean 23.1% of clinic cohorts) were enrolled and followed up for between 12 and 30 months each. Demographics were representative of clinic cohorts: 91% male (2048/2251) ; 71% MSM (1598/2251) ; 27.9% aged over 50 (629/2251) ; 20.4% (460/2251) non-national at site. Virological outcomes remained excellent (10/2251 with confirmed VL > 50 ; none lost to clinical follow- up) ; no SAEs related to the pathway were reported. Patients were highly activated, no clinically important change was observed in PAM-13 score ; adjusted average continuous PAM-13 score at M12 compared to M0 -0.95 (99% CI -2.10, 0.19). Median self-reported adherence was 100% at each time point. Health-related quality of life was generally good although pain/discomfort and anxiety/depression were common (up to 34% and 44% respectively at M12) on EQ-5D-5L. Stigma was the lowest scoring domain of PROQOL-HIV. The usability of the platform was excellent [SUS score 85 at M12 and M24] ; 94.6% would recommend EmERGE to a friend. Conclusions: This co-designed digital health supported pathway offers a secure, safe, feasible and acceptable option for routine care to people living with medically stable HIV: providing individuals with access to their data and other information whilst helping clinics to manage capacity.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA