Addressing the whole patient
The hope is that the report will lead to increased awareness among caregivers to address the whole patient and the struggles they face alongside HIV infection.
“Other related health behaviors and outcomes may often need to be addressed in the context of more than solely HIV,” Parsons said. “Conversely, for the older person living with HIV, issues around HIV management operate within a wider context of comorbidities and behaviors.”
One way to address comorbidities driven by behavior is with a commitment contract, according to a report published in AIDS. The study investigated whether behavior contracts that incentivized compliance with recommended care plans improved health outcomes. The research team found that patients in the incentivized group had improved anti-retroviral therapy adherence and viral suppression at the conclusion of the study.
Marcella Alsan, MD, MPH, PhD, lead author of the report and assistant professor at the Stanford School of Medicine in California, , said the contracts were effective in improving adherence to HIV regimens because it gave patients more control over their healthcare.
“My hope is that physicians and medical providers recognize the role that modifying the choice architecture can play in improving health outcomes,” Alsan, core faculty at the Center for Health Policy/Primary Care Outcomes Research at Stanford, said. “Our research on commitment contracts for HIV treatment adds to a growing body of evidence—including obesity and smoking—on how behavioral economics can be leveraged to improve health.”