Introduction: By 2015, more than 50% of individuals with HIV in the US will be over the age of 50. HIV-infected patients experience both accentuated and accelerated aging, resulting in multiple chronic conditions that are more pronounced and earlier in onset compared to their uninfected counterparts. As HIV-infected patients may appear older than their chronological age and are too young to be cared for by geriatricians, HIV clinicians are tasked with managing multiple age-related illnesses, a skill not usually included in their infectious disease training. This resource aims to alleviate this problem by providing HIV providers with an evidence-based approach on how to manage common geriatric syndromes encountered in the newly emerging elderly HIV-infected population. Methods: The HIV and Aging Curriculum was created utilizing the same format and process as the Yale Office-Based Medicine Curriculum, used in more than 200 internal medicine and family medicine residency programs, as well as in many nursing and medical schools. The curriculum consists of two components: the learner guide and the instructor guide. The learner guide consists of topical cases, applicable questions, bibliography of reading assignments, and bibliography of online peer-reviewed additional references. The instructor guide includes suggested teaching points and answers to the case questions. The highlights of this curriculum are the realistic, engaging cases and challenging questions that accentuate the practical aspects of diagnosis and management. The lessons utilize not only information recall but also higher order cognitive skills, such as evaluating new information, weighing risks and benefits, making treatment decisions, and implementing counseling skills through hypothetical scenarios. Results: The effectiveness of the Yale Office-Based Medicine Curriculum format and its creation process is well validated. The curriculum offers high-quality presentations, with well-chosen references, engaging cases, and clear didactic materials that are evidence-based and reflective of real-world practice. Overall, the curriculum saves development time, delivers high-quality content, and provides good learner satisfaction. Discussion: Since most currently available information on the care of aging HIV-infected individuals is in the form of extensive articles without examples of applications to patient cases, the case-based structure of the curriculum presents the materials in a manageable format that reflects the nuances and complications of real-world practice.
- Identify two geriatric syndromes that are more common among HIV-infected patients compared to the general population and list at least one risk factor for these conditions that are found only in HIV-infected patients.
- Utilize two instruments that can be used during clinic visits to examine geriatric syndromes in HIV-infected patients.
- Select and justify the necessity of two lab tests used to evaluate a geriatric syndrome found in HIV-infected patients.
- Explain how to modify an HIV-related risk factor for a common geriatric syndrome.
- Give three examples of medications for geriatric syndromes that interact with antiretroviral therapy and describe the mechanism of interaction.
- Choose a geriatric syndrome that is managed similarly between HIV-infected and HIV-uninfected patients and outline two management strategies related to that syndrome.
- Centers for Disease Control and Prevention. HIV surveillance report. http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Accessed February 1, 2011.
- Key NA, Al-Hihi E, Whittle J. To buy or build: deciding on an ambulatory resident’s curriculum. SGIM Forum. 2005;28(1):6-14.
- Pangaro, L. A new vocabulary and other innovations for improving descriptive in-training evaluations. Acad Med. 1999;74:1203–1207. http://dx.doi.org/10.1097/00001888-199911000-00012
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