The development of a multidisciplinary, evidence-based guideline for “HIV and employment”

Abstract

The objective of this study was to develop a multidisciplinary guideline that supports the care and vocational rehabilitation of HIV-infected people with employment-related problems. The guideline was developed according to the “evidence-based guideline development” method developed by the Dutch Institute for Health Care Improvement. This method consists of the following steps: forming a multidisciplinary core group and an expert panel, formulating key questions, searching and appraising the available literature, formulating considerations and recommendations, peer reviewing the draft guideline, and authorizing the final guideline. All relevant professional associations were represented in the core group that was assembled to develop the guideline, i.e., HIV doctors, HIV nurses, general practitioners, occupational health physicians, psychologists, social workers, occupational health nurses, vocational experts, and insurance physicians. Five key questions for the guideline were formulated with the following themes: determinants of employment, disclosure and stigma, self-management, interventions, and the organization of care. In the literature review on these topics, 45 studies met the inclusion criteria. The methodological quality of the included articles was poor. Factors such as patient preferences and medical/ethical issues were considered. The recommendations in the guideline are a weighting of the scientific evidence and the considerations of the core group. The guideline, as well as its summary for daily practice, clarifies the most important barriers and facilitators to people with HIV either staying at work or returning to work, and it constitutes a clinical, easy-to-use guideline for health-care providers and how they can support people with HIV who want to work.

Keywords:

• HIV
• employment
• guideline as a topic
• vocational rehabilitation
• organization of care

Acknowledgments

P.D.D.M.R. contributed by search of studies, review of studies, and preparation of the study. H.S.M. contributed by revising the study from a health and work perspective. D.P.M.B. contributed by revising the study from a clinical perspective. R.D. contributed by revising the study from a rehabilitation medicine perspective. E.M.C.G. contributed by concept development and revising the study from a clinical perspective. M.N.W. contributed by concept development, search of the studies, review of the studies, and preparation of the study. The authors would like to thank Mrs. Winnie Schats, head of library Slotervaart Hospital, for her help in the literature search and Mr. John Widen, native English speaker/translator, for checking the English spelling.

Funding

This study was supported by ZonMw, The Netherlands Organisation for Health Research and Development.

Additional information

Funding

Funding: This study was supported by ZonMw, The Netherlands Organisation for Health Research and Development.