Advance care planning and documentation of goals of care designation among adults (≥18 years) living with human immunodeficiency virus (HIV): A cross-sectional study.

Abstract

Objectives: Antiretroviral therapy has transitioned human immunodeficiency virus (HIV) into a manageable chronic condition. As such, advance care planning is critical to providing patient-centered care for aging persons with HIV. The objectives of the study were to determine the proportion of adults living with HIV in Southern Alberta with a documented goals of care designation and explore factors influencing this documentation.

Results: Ten percent (255/2567) of adults with HIV had a goal of care documentation in the electronic health record. Documentation did not differ by age, sex, or family physician status. Among patients with an ED visit in the prior year, 21% (225/1065) had a goal of care documentation compared to 2% of those without (p < 0.0001). Among those hospitalized in the prior year, 56% (203/364) had a goal of care documentation, compared to 2% of those without (p < 0.0001).

Significance of results: A minority of adults living with HIV had a goal of care documentation.. These findings highlight missed opportunities and areas for improvement for advanced care discussions. There is an urgent need to enhance advanced care planning in this population.