A"review"of"referrals"and"interventions"within"a"specialis

t"HIV"outpatient"
Physiotherapy"service""
D.#Brown#(MSc#!#Dr#M.#"elson#
#helsea#and#$est%inster#"HS#&oundation#'rust#
Source"of"(eferral
"
Bac)*round+"
"
As#people#live#longer#with#HIV#with#increasing#
comorbidities#and#above#average#risk#for#cardiovascular,#
metabolic,#bone#and#neurological#problems,#chronic#long<
term#condition#management#is#increasingly#relevant(1!##
Attention#to#physical#dimensions#of#patient#care#is#
suggested#to#optimise#well<being(#!##$oor#physical#
function#in#HIV#outpatients,#including#mobility#problems,#
pain#and#reduced#self<care#are#associated#with#worse#self<
reported#health#status(#!##$hysiotherapy#aims#to#optimise#
function,#well<being#and#promote#self<management!#%his#
review#aims#to#identify#sources#of#referral#into#a#specialist#
HIV#outpatient#$hysiotherapy#service,#the#reason#for#
referral#and#interventions#received!#%he#aim#is#optimise#
service#delivery#to#address#patient#re&uirements!#
Methods+"
"
'ata#was#collected#for#all#HIV#patients#referred#to#HIV#
outpatient#$hysiotherapy#between#(ebruary#and##
'ecember##)1#!#
HIV"Associated"#onditions"
(esults+"
"
*##patients#were#referre
d#to#HIV#outpatient#$hy
siotherapy!###+),#
were#male,#median#age
#-#yrs#(range#.#<*+yrs
,#-),#aged#-)#and#
over!###/,#had#a#dual
#HIV#and#Haemato<0nco
logical#diagnosis!#
HIV#clinicians#referred#1)
,#of#patients#and#other
#referrals#were#
via#$hysiotherapists#a
nd#0ccupational#%her
apists#(12,,#
'ieticians#(1#!-,,#3urs
e#specialists#(1#!-,,#
0ncology4$alliative#
care#5linicians#(11!1,
#and#$sychologists#(
#!*,!#
##
%he#most#fre&uent#rea
sons#for#referral#were#
musculoskeletal#
(./!1,,#neurological#
(1-!.,,#reduced#e6er
cise#tolerance#
(11!1,#and#pain#manag
ement#(+!*,!###,#were
#not#HIV#related#
conditions!#
##
%he#most#fre&uent#$hy
siotherapy#interventions
#consisted#of#171#
treatment#(1/,#or#171
#followed#by#a#twice#
weekly,#1)<week#
group#HIV#rehabilitation
#programme#(#*,!##.
),##of#patients#
were#referred#to#the
#group#rehabilitation
#programme!##/!.,
#did#
not#attend#171#an
d#were#discharged!
#*!+,#received#an
#onward#
referral#to#e6tern
al#services!#Hydro
therapy#and#171#
were#
provided#to#1!/,
#of#patients!#
#onclusi
on+"
"
8eferrals#to#a#s
pecialist#HIV#out
patient#$hysioth
erapy#
service#come#f
rom#a#range#o
f#multidisciplina
ry#
professionals!#9es
s#than#a#&uarter
#were#non<HIV#r
elated#
conditions#withi
n#an#ageing#p
opulation,#referr
ed#for#
diverse#reasons!
#%he#ma:ority#o
f#patients#re&uir
e#171#
$hysiot
herapy
#or#a#
twice#
weekly,
#1)<w
eek#gr
oup#HI
V#
rehabilit
ation#p
rogram
me!#%h
is#re;e
cts###
key#ser
vice#
provisio
n#re&u
irement
s#for#t
his#pat
ient#co
hort!#
I%p
licat
ions
+"
"
'elivery
#of#an
#HIV#o
utpatient#$hysiotherapy#service#
(eason"for
"(eferral"
Physio
therap
y"Inter
ventio
n"
re&uires#both#171#clinics#and#group#HI
V#rehabilitation#
#ontact+#Darren.Brown,chelwest.nhs.u)#
programmes#to
#address#divers
e#patient#needs
!#
1) <HIVA#
standar
ds#of#
care#f
or#peo
ple#livi
ng#
with
#HIV
=##)
1.#
2) Harding#et#al!#>hat#factors#are#
associated#with#patient##
self<reported#health#status#among#HIV#out
patients?
#A#multi<cent
re##
@A#study#of#biomedical#and#psychosocial#factor!#AI'B#5are,##)1#=#1(27+/. <+*1#