Patient perspectives on integrated healthcare for HIV, hypertension and type 2 diabetes: a scoping review

Singh, Sabine, Kirk, Ole, Jaffar, Shabbar ORCID: https://orcid.org/0000-0002-9615-1588, Karakezi, Catherine, Ramaiya, Kaushik, Kallestrup, P and Kraef, Christian (2021) 'Patient perspectives on integrated healthcare for HIV, hypertension and type 2 diabetes: a scoping review'. BMJ Open, Vol 11, Issue 11, e054629.

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Abstract

Introduction
Antiretroviral therapy has reduced mortality and led to longer life expectancy in people living with HIV. These patients are now at an increased risk of non-communicable diseases (NCDs). Integration of care for HIV and NCDs has become a focus of research and policy. In this article, we aim to review patient perspectives on integration of healthcare for HIV, type 2 diabetes and hypertension.

Methods
The framework for scoping reviews developed by Arksey and O'Malley and updated by Peter et al was applied for this review. The databases PubMed, Web of Science and Cochrane library were searched. Broad search terms for HIV, NCDs (specifically type 2 diabetes and hypertension) and healthcare integration were used. As the review aimed to identify definitions of patient perspectives, they were not included as an independent term in the search strategy. References of included publications were searched for relevant articles. Titles and abstracts for these papers were screened by two independent reviewers. The full texts for all the publications appearing to meet the inclusion criteria were then read to make the final literature selection.

Results
Of 5502 studies initially identified, 13 articles were included in this review, of which 11 had a geographical origin in sub-Saharan Africa. Nine articles were primarily focused on HIV/diabetes healthcare integration while four articles were focused on HIV/hypertension integration. Patient’s experiences with integrated care were reduced HIV-related stigma, reduced travel and treatment costs and a more holistic person-centred care. Prominent concerns were long waiting times at clinics and a lack of continuity of care in some clinics due to a lack of healthcare workers. Non-integrated care was perceived as time-consuming and more expensive.

Conclusion
Patient perspectives and experiences on integrated care for HIV, diabetes and hypertension were mostly positive. Integrated services can save resources and allow for a more personalised approach to healthcare. There is a paucity of evidence and further longitudinal and interventional evidence from a more diverse range of healthcare systems are needed.

Item Type:	Article
Subjects:	WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections WG Cardiovascular System > Heart. Heart Diseases > WG 200 General works WK Endocrine System > WK 810 Diabetes mellitus
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1136/bmjopen-2021-054629
Depositing User:	Rachel Dominguez
Date Deposited:	08 Dec 2021 11:21
Last Modified:	08 Dec 2021 11:21
URI:	https://archive.lstmed.ac.uk/id/eprint/19577

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