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Abstract
Despite the introduction of HAART, pain is still a common symptom in people living with HIV/AIDS. For these persons, pain management supplied by palliative care teams may support standard HIV care. This study compares opinions toward palliative care of 83 HIV specialists and 217 oncologists (French national survey: Palliative Care 2002). Data were collected by phone questionnaire. A cluster analysis was carried out in order to identify contrasted profiles of opinions toward palliative care. A logistic regression was performed to test the relationships between identified clusters and physicians’ characteristics. With a two-cluster partition, we observed a profile corresponding to a restrictive conception of palliative care. Within this profile, physicians were more prone to consider that palliative care should be used only for terminally-ill patients, and only after all curative treatments have failed, with a restrained prescriptive power for physicians providing palliative care. This conception was associated with reluctance toward morphine analgesia. Once controlled for other physicians’ characteristics, HIV specialists were more likely than oncologists to endorse this restrictive conception (OR=1.9, CI95% [1.1; 3.3]). Thus French HIV specialists should be more informed about the utility of providing palliative care, even for patients who are not in terminal stage.
Acknowledgments
Special thanks to the members of the South-Eastern France Palliative Care Group: M. K. Ben Diane, Dr R. Favre, Dr A. Galinier, Dr H. Granier, Dr JM. Lapiana, Dr Y. Obadia, Dr H. Pégliasco, Dr B. Planchet-Barraud, Dr F. Ravallec, Dr M. Rotily and Dr O. Priolo.
This study was supported by the Departmental Centre of Private Health Professionals (grant from the Fund for improving ambulatory care), by the Assistance Publique-Hôpitaux de Marseille (within the hospital program for clinical research) and by the Cancer Research Foundation (ARC).