Once a full picture of an individual’s health status is clear, and a shared understanding of their QoL objectives has been reached, the crux of the ‘Health Goals for Me’ framework is to find interventions that can help them achieve these goals.
While a collaborative approach is still vital for this stage of the framework, it’s important for the HCP to know which interventions can help – whether it is treatment change, lifestyle adaptation, counselling, referral to another specialist, or another intervention.
Some people living with HIV will naturally feel more empowered and confident in contributing to this process; however, it is the role of the HCP to identify the extent to which each person is willing and able to be involved in decision-making, and how to support each person to live healthily with HIV.
No two people living with HIV are the same, but many share characteristics, experiences and challenges that can serve as examples of how to approach a treatment journey. The following case studies are real examples of the 'Health Goals for Me' framework put into practice to find solutions for QoL issues.
Not all quality of life issues are immediately apparent. In this case study, Dr Joop Arends talks about how objective measurement of QoL can reveal issues that were undisclosed during informal assessment.
Dr Adrian Curran discusses how he worked together with a young patient to overcome her fear of stigma, which he suspected to underlie a number of other QoL issues.
The Health Goals for Me framework is a cycle for ongoing practice. In this case study, Dr Giovanni Guaraldi demonstrates how he used the steps of the framework to address evolving QoL issues across a patient’s journey.
Treatment recommendations for the patient QoL domains and key factors outlined in the ‘Health Goals for Me’ framework can be found across international HIV treatment guidelines, from bodies such as EACS and WHO, as well as guidelines from regional healthcare bodies.
These recommendations should serve as the foundation of the intervention plan that HCPs and their patients develop together. However, guidelines can only go so far in predicting the QoL needs of individual people living with HIV; where appropriate, don’t be afraid to break new interventional ground when a patient’s needs aren’t covered by the books.
EACS: European AIDS Clinical Society; HCP: healthcare professional; QoL: quality of life; WHO: World Health Organisation.