Chronic Pain, Functional Status, and Life Satisfaction Are Associated With Patients Living With HIV Discussing Advance Care Planning With Their Family or Friends

Eric D Hansen; Mary M Mitchell; Dulce M Cruz Oliver; Fahid A Alghanim; Michelle Walter; Amy A Case; Tom Smith; Amy R Knowlton

doi:10.1016/j.jpainsymman.2019.02.018

Chronic Pain, Functional Status, and Life Satisfaction Are Associated With Patients Living With HIV Discussing Advance Care Planning With Their Family or Friends

J Pain Symptom Manage. 2019 May;57(5):961-965. doi: 10.1016/j.jpainsymman.2019.02.018. Epub 2019 Feb 25.

Authors

Eric D Hansen¹, Mary M Mitchell², Dulce M Cruz Oliver³, Fahid A Alghanim⁴, Michelle Walter⁵, Amy A Case⁵, Tom Smith³, Amy R Knowlton⁶

Affiliations

¹ Department of Supportive Care, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA. Electronic address: eric.hansen@roswellpark.org.
² Friends Research Institute, Baltimore, Maryland, USA.
³ Palliative Medicine Program, Johns Hopkins Hospital, Baltimore, Maryland, USA.
⁴ Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.
⁵ Department of Supportive Care, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
⁶ Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Abstract

Context: In the era of effective antiretroviral therapy, persons living with HIV/AIDS (PLWHA) are living longer, transforming HIV from a universally fatal disease to a serious chronic illness, warranting discussions between patients and their loved ones about advance care planning (ACP). Evidence is needed on factors associated with patients' likelihood to discuss ACP with loved ones.

Objectives: To further characterize factors associated with successful ACP in PLWHAs with their loved ones, we examined associations between patients having ACP discussions with the need for assistance with personal care, chronic pain, life satisfaction, prior family disagreements over health care decisions, sex, age, and interference in daily routines due to memory problems.

Methods: Data were from the Affirm Care study (N = 370), which examined social and environmental factors associated with health outcomes among PLWHAs and their informal caregivers.

Results: Slightly more than half of respondents discussed ACP with loved ones (57%). In adjusted analysis, higher levels of chronic pain (odds ratio [OR] = 2.09, P = 0.045), needing assistance with personal care (OR = 1.63, P = 0.023), greater life satisfaction (OR = 1.02, P = 0.002), prior family arguments over health care decisions (OR = 2.80, P < 0.001), and female sex (OR = 2.22, P = 0.001) were associated with higher odds of discussing ACP with loved ones, whereas age, drug use, education level, depression, and memory problems were nonsignificant.

Conclusion: These results suggest that interventions to increase ACP among PLWHAs and their loved ones should target males. The findings also suggest PLWHAs with chronic pain, the need for assistance with personal care, and those with a history of prior family arguments over health care decisions may be primed for ACP.

Keywords: AIDS; African American or black; advance care planning; chronic pain; family or caregiver.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Advance Care Planning*
Aged
Caregivers
Chronic Pain / complications*
Chronic Pain / psychology
Cross-Sectional Studies
Family
Female
Friends
HIV Infections / complications
HIV Infections / psychology*
HIV Infections / therapy*
Health Communication*
Humans
Male
Memory Disorders / complications
Middle Aged
Personal Satisfaction*
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding