Approximately 100,000 people in the UK are estimated to be living with HIV. As the UK exceeds the United Nations’ 90-90-90 targets for diagnosis, treatment and viral suppression, at least 98% of people living with HIV (PLWH) use long-term antiretroviral therapy.1 Despite the undoubted clinical benefits of ART, PLWH may be faced with demands and consequences of polypharmacy related to using HIV and non-HIV medicines. How this growing and aging population are able to manage their medicines in the context of HIV and co-morbidities is not well understood. PLWH may face various challenges, both pharmaceutical (e.g. size and number of medicines) and social, in adhering to their daily regimen, with a range of interventions which may prove effective, for example, alternative antiretroviral formulations and adherence support.2
Treatment burden and regimen fatigue impact on patients’ quality of life, adherence, and engagement with care.2-5 This PhD project will use mixed methods to investigate patients’ perspectives of polypharmacy and treatment burden in the context of long-term HIV care. We have developed and validated a novel patient-reported outcome measure, the Living with Medicines Questionnaire, LMQ,6 which has revealed a range of psychosocial and practical issues that warrant further investigation in this patient population. In tandem with this qualitative work using a range of methods will allow the project to elaborate on these themes and expand our understanding of the pressures at play for different individuals. This study will build on ongoing work through existing collaborations with different patient organisations and NHS Trusts.
The PhD candidate will work with a multidisciplinary team to shape the research programme, as well as early discussions with stakeholder groups, but methods and areas of investigation could include:
1) the extent to which medicines burden affects PLWH in the UK, how this is experienced as well as its associations with other factors (social stigma, adherence, quality of life).
2) the impact of medicines burden on clinical and mental health outcomes for a sub-sample, based on the hypothesis that higher medicines burden is associated with poorer clinical outcomes and mental health.
3) the impact of aging and polypharmacy on PLWH
Data obtained will facilitate development of targeted interventions to support people experiencing difficulties with multiple treatments for HIV and/or other co-morbidities.
This multidisciplinary research programme is based on a collaboration between Pharmacy and Medical anthropology: Dr Barbra Katusiime, Dr Sarah Corlett, Prof Janet Krska and Dr Rebecca Cassidy, whose work focuses on patients’ experiences with long-term treatments and the impact of HIV treatment and its social context.
Applicants should have, or expect to obtain, a first class or upper second class degree and/or Masters degree in a relevant discipline (Social Science, Sociology, Anthropology, Psychology, Pharmacy or other health disciplines). Above all, candidates should be highly motivated, independently-minded and should be able to work in patient-facing environments. Experience with recruitment of difficult-to-reach patient populations will be an added advantage. International (non-EU) candidates may apply, as well as self-funded applicants.
Further information about entry requirements and information for international students can be found at: https://www.kent.ac.uk/courses/postgraduate/783/pharmacy#entry-requirements
To apply for this position, please send your CV and cover letter detailing research interests, as well as names/addresses of potential references to Dr Barbra Katusiime ([email protected]
More information about our research group can be found at: https://www.msp.ac.uk/research/cpp-team/clinic-prof-pract-use.html
1.Public Health England. Progress towards ending the HIV epidemic in the United Kingdom: report. November 2018
2.Tran VT et al. Patients’ perspectives on how to decrease the burden of treatment: a qualitative study of HIV care in sub-Saharan Africa. BMJ Quality & Safety. 2018. doi: 10.1136/bmjqs-2017- 007564
3. Krska, J, Corlett, SA, Katusiime B. Complexity of medicine regimens and patient perception of medicine burden. Pharmacy 2019, 7(1) doi: 10.3390/pharmacy7010018
4. Katusiime B, Corlett S, Reeve JL, Krska J. Measuring medicines related experiences from the patient perspective: a systematic review. Patient Related Outcome Measures. 2016; 7: 157–171
5. Krska J, Katusiime B, Corlett SA. Patient experiences of the burden of using medicines for long-term conditions and factors affecting burden: A cross-sectional survey. Health & Social Care in the Community. 2018. 26(6):946-959.
6. Katusiime B, Corlett SA, Krska J. Development and validation of a revised instrument to measure burden of long-term medicines use: the Living with Medicines Questionnaire version 3. Patient Related Outcome Measures. 2018. 9: 155-168.