REACH: Retention and Engagement Across Care services for HIV v1
Research type
Research Study
Full title
The REACH study: exploring patterns of retention and engagement across specialised care services for HIV positive patients in the United Kingdom (UK)
IRAS ID
128774
Contact name
Fiona Margaret Burns
Contact email
Sponsor organisation
University College London
Research summary
Almost 100,000 adults are estimated to be living with HIV in the UK. Among those aware of their infection, almost one in five are ‘lost to follow up’. Maintaining HIV patients in care is vital for them to benefit from effective therapies and reduces transmission of HIV. Missed appointments also have significant cost ramifications.
We will define the patterns of HIV outpatient attendance in the UK and increase our understanding of the characteristics and lifestyle factors of patients who engage poorly with services.
Phase one: to examine patterns of HIV outpatient attendance. We will analyse existing data from UK HIV services, collected by the UK Collaborative HIV Cohort (UK CHIC) study. We will determine the health consequences and the financial costs associated with attendance patterns. We will identify factors predicting disengagement from care and develop a tool for clinicians to identify patients at risk of disengagement.
Phase two: to explore patients’ experience of services. Patients attending five London HIV clinics will be surveyed about environmental, behavioural and social factors influencing service attendance. We will interview 40 patients about their experiences, service preferences and perceived barriers to accessing HIV services. Four community focus groups will be conducted to gain a wider perspective of contextual factors. We will calculate the cost of missed clinic appointments to the NHS.
Phase three: up to 25 service providers will be interviewed about their perceptions of barriers to engagement in care, how services could be adapted to optimise patient engagement, and what would be operationally feasible. Information from phases two and three will help generate a list of potential interventions to improve and optimize engagement. The costs of potential interventions will be calculated.
This work will help improve efficiency and health outcomes by enhancing patient-centred care. It will be relevant to clinicians, service providers and policy makers.
REC name
London - Bromley Research Ethics Committee
REC reference
14/LO/0039
Date of REC Opinion
16 Jan 2014
REC opinion
Favourable Opinion