In a four-year study, researchers at the University of Pennsylvania found benefits to assigning adults with serious mental illness who are HIV positive to the care of advanced practice nurses.
The APRNs were able to help the patients in the study navigate the healthcare system and maintain adherence to drug regimens. Patients cared for by APRNs showed depression and improved overall physical health, and the researchers said their findings indicate healthcare policy should be revamped to provide this support.
“Implementation of community-based nurse management using APRNs for complex patient populations may improve long-term outcomes and reduce the high costs of care,” lead study author and Penn Nursing professor Nancy P. Hanrahan, RN, PhD, said in a news release.
“This study suggests that APRN care management should be a central component of the redesign of healthcare delivery to this vulnerable population.”
The authors wrote that APRNs “facilitated improvement through a combination of education, medication management and advocacy within the health system. These findings are consistent with a growing body of literature that suggests that care management models are beneficial for vulnerable populations.”
Adults with serious mental illnesses die, on average, 25 years earlier than the rest of the population. Because of their illness, these adults often live in poverty or in disadvantaged neighborhoods and are more likely to abuse controlled substances and suffer cognitive impairment.
This convergence of factors often complicates the process for these adults of navigating the complex requirements of today’s healthcare system, the researchers said, which can in turn cause their health to spiral downward.
Those adults with serious mental illnesses such as schizophrenia and bipolar disorder might then engage in risky behaviors, such as casual sexual relationships or intravenous drug use, that infect them with HIV. Continued risky behavior, sometimes fueled by a lack of adherence to prescribed medications for their mental health condition, promotes the spread of the virus.
The study appeared in Nursing Research and Practice: http://www.hindawi.com/journals/nrp/2011/840248/.