The Influence of Patient Experience with Healthcare on the Health-Related Quality of Life of People Living with HIV: An Observational Cross-Sectional Survey

Abstract

INTRODUCTION: Patient experience is central to the quality of healthcare delivery, showing positive associations with several outcome measures. The main objectives of this study are to analyze the influence of patient experience on the health-related quality of life in people living with HIV and the role played by treatment complexity and clinical care. METHODS: We conducted a cross-sectional survey with 467 patients with HIV. We used the Instrument for Evaluation of the Experience of Chronic Patients and the Health-related Quality of Life Questionnaire (EQ-5D-5L). We analyzed a predictive model through the partial least squares (PLS) method. RESULTS: The patient self-management scores showed the highest positive relationship with the patient's health-related quality of life (beta = 0.24, beta = 0.32, p < 0.0001). Patients' treatment complexity had a negative influence on health-related quality of life (beta = - 0.21, beta = - 0.28, p < 0.0001). The complexity of clinical care had negative effects on health-related quality of life, both directly (beta = - 0.37, beta = - 0.19, p < 0.0001) and through its negative influence on the productive interactions with healthcare professionals (beta = - 0.21, p < 0.0001) and patient self-management factors (beta = - 0.21, p < 0.0001). The effects of patient experience dimensions on their health-related quality of life were higher in people living with HIV > 50 years old (p < 0.05). CONCLUSIONS: Patient experience mainly influenced the health-related quality of life of older people living with HIV. The treatment and clinical care complexity played an important role in degrading the patients' experience and their quality of life. More integrated care would benefit the health-related quality of life of people living with HIV. FUNDING: This project was funded by Merck Sharp & Dohme, Spain.