3 Feb 2017

Healthmap putting HIV patients on the road to better health

L-R: Andrew Way (Alfred Health CEO), Dr Julian Elliott and
Professor Sharon Lewin (Doherty Institute Director)
by Anne Crawford

A novel program that helps people with HIV manage their own health is striking a chord with participants in an Australia-wide trial led by Monash University and Alfred Hospital researchers.

HealthMap links people with HIV with health care coaches in a program aimed at countering the increased risk of diseases associated with the lifelong illness, such as heart attack and cancer. The program uses phone-based coaching and an online shared health record to give participants a clear summary of their health status and support and resources to improve their health and quality of life.

Dr Julian Elliott, Director of Clinical Research in the Infectious Diseases Unit at The Alfred, said that whilst HIV was no longer the life-threatening illness it once was, that people with the disease were more prone to certain diseases, due mainly to the high prevalence of risk factors such as smoking and high cholesterol.

“HealthMap is helping people with HIV address these risk factors, working together with their doctors, nurses and others to reduce their risk of heart attack, cancer and other illnesses,” Dr Elliott said.

“In general the more capacity people have for managing their conditions, the healthier they are and the better their long-term outcomes,” he said. “It’s important to understand the effects these programs can have on the health of people with HIV.”

To this end, a cluster randomised trial involving about 600 people with HIV at clinical sites around Australia began in late 2014 with data collected at baseline, six and 12 months.

Dr Elliott and Professor Sharon Lewin, now Director of the Doherty Institute, were awarded $1.5 million in NHMRC funding in 2011 to develop the HealthMap program and perform the clinical trial. Alfred Health contributed an additional $1 million and support was also provided by the National Association of People with HIV Australia and the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine.

“The trial’s going well,” Dr Elliott said. “It’s large and complex – a lot of time and effort has gone into running it, following people up and keeping them engaged.

“People really appreciate the opportunity to have access to their own lab results and to have their own health care coach,” he said.

The participants said they appreciated having someone supportive to talk to, who helped them with their issues, setting goals and trying to find solutions. They said they liked being coached from the comfort of their own home, and at their own pace.

“The information and support offered from the relationship was very empowering,” said one participant. “It bolstered my commitment to more improved health, through goal achievement which built on input from my doctor".

"The most genuine value for me was that the program refreshed and reminded me of valuable tools to use when I was having a bad day, feeling low or depressed etc.,” another participant said.

"Without HealthMap, I may have continued to keep my head in the sand and pretend everything was okay,” said another. “Now I feel more confident about myself and my future. I also realise that true well-being results from healthy choices are not just for the body, but the mind and soul as well".

The study, which has involved seven other universities, is still in progress with the final data expected in March this year.

If effective, the HealthMap model may become a widespread system for supporting the care of people with HIV.

For information detailing how the trial is being conducted see the protocol paper:

Dodson S, Klassen KM, McDonald K, Millard T, Osborne RH, Battersby MW, Fairley CK, Simpson JA, Lorgelly P, Tonkin A, Roney J, Slavin S, Sterjovski J, Brereton M, Lewin SR, Crooks L, Watson J, Kidd MR, Williams I, Elliott JH. HealthMap: a cluster randomised trial of interactive health plansand self-management support to prevent coronary heart disease in people with HIV. BMC Infect Dis. 2016 Mar 5;16:114. doi: 10.1186/s12879-016-1422-5.

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