Strengths and Challenges of Various Models of Geriatric Consultation for Older Adults Living With Human Immunodeficiency Virus

Author:

Davis Amelia J1,Greene Meredith2,Siegler Eugenia3,Fitch Kathleen V4,Schmalzle Sarah A5,Krain Alysa6,Vera Jaime H7,Boffito Marta8,Falutz Julian9,Erlandson Kristine M10

Affiliation:

1. University of Colorado–Anschutz Medical Campus, School of Medicine, Aurora, Colorado, USA

2. Department of Medicine, Division of Geriatrics, University of California–San Francisco, San Francisco, California, USA

3. Department of Medicine, Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA

4. Department of Medicine, Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA

5. Department of Medicine, Division of Infectious Disease, University of Maryland School of Medicine, Baltimore, Maryland, USA

6. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA

7. Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, United Kingdom

8. Department of HIV Medicine, Division of Geriatric Medicine, Chelsea and Westminster Hospital, London, United Kingdom

9. McGill University Health Center, Montreal, Canada

10. Department of Medicine, University of Colorado–Anschutz Medical Campus, Aurora, Colorado, USA

Abstract

Abstract As care of persons living with human immunodeficiency virus (HIV; PWH) has transitioned from management of opportunistic infections to management of conditions associated with older age, new models of geriatric consultation are needed. The authors, who represent 9 clinics across North America and the United Kingdom, provided their insights on models of geriatric consultation for older PWH. Three models of geriatric consultation are delineated: outpatient referral/consultation, combined HIV/geriatric multidisciplinary clinic, and dually trained providers within 1 clinical setting. A patient-centered approach and the use of expertise across disciplines were universally identified as strengths. Logistical barriers and the reluctance of older PWH to see a geriatric care provider were identified as barriers to implementing these models. Although the optimal model of geriatric consultation depends on a region’s resources, there is value in augmenting the training of infectious disease providers to include principles of geriatric care.

Funder

National Institutes of Health

National Institute on Aging

Infectious Diseases Society of America

Gilead Sciences

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Reference24 articles.

1. The aging population with HIV infection;Wing;Trans Am Clin Climatol Assoc,2017

2. Older people with HIV are an essential part of the continuum of HIV care;Siegler;J Int AIDS Soc,2018

3. Roles of Geriatrics Health Professionals/What Geriatrics Can Add To Care of Older Adults with HIV;Carmen,2018

4. The looming geriatrician shortage: ramifications and solutions;Lester;J Aging Health,2020

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