Nurse-led palliative care for HIV-positive patients taking antiretroviral therapy in Kenya: a randomised controlled trial

摘要: Summary Background People with HIV accessing antiretroviral therapy (ART) have persistent physical, psychological, social, and spiritual problems, which are associated poor quality of life treatment outcomes. We assessed the effectiveness a nurse-led palliative care intervention on patient-reported Methods did this randomised controlled trial at clinic in Kenya for adults HIV, established ART, reporting moderate-to-severe pain or symptoms. randomly assigned participants (1:1) either to (including assessments emotional, wellbeing life) given six times over 4 months, usual care. Participants investigators were not masked allocation. The primary outcome was (scored African Palliative Care Association's Outcome Scale). This is registered ClinicalTrials.gov, number NCT01608802. Findings screened 2070 patients, whom we enrolled 120: 60 allocated each group. In control group, median score improved from 1·0 (IQR 0·0–2·0) baseline 5·0 (3·0–5·0) months; it (0·0–2·0) 4·5 months. Compared standard care, had no significant effect (coefficient −0·01, 95% CI −0·36 0·34, p=0·95). Interpretation A effective reducing pain. However, person-centred assessment delivered by staff who received additional training positive effects self-reported mental health related psychosocial wellbeing. Funding Diana Princess Wales Memorial Fund.