P-461. Positive Aging Consultations: A Model for Expanding Geriatric HIV Care

Abstract Background People living with HIV (PWH) experience geriatric syndromes commonly found in much older populations and may benefit from geriatrician consultation. We aim to describe a referral-based model at the University of Colorado. Methods The Positive Aging Consultations, a referral-based model, sought to connect high-risk PWH ≥ 50 years old with geriatric care. High-risk patients (experiencing geriatric syndromes, polypharmacy, multimorbidity, or advance care planning needs) were referred for geriatric consultation at the UCHealth Seniors Clinic; those taking ≥ 10 medications were referred for clinical pharmacy consultation. Patients were screened for functional status, preventative care, socioenvironmental factors (living situation, food access, transportation, social support, and elder abuse), and cognitive/mental health concerns (depression, anxiety, and memory loss). Geriatricians placed orders or communicated recommendations to the patient’s primary HIV provider. HIV providers completed a survey about their experience with the program. Additional data was collected via chart review. Results From January 2018 to July 2019, 11 patients underwent geriatric consultation. The average age was 69 years old (SD=7; range 59-80). Geriatricians most often made recommendations regarding referral to other health or community-based services (n=9), medication changes (n=8), osteoporosis screening (n=6), and memory loss management (n=5). Advance directives were discussed in all visits. All but one HIV provider (n=7) said they would refer patients to the program in the future. Conclusion The Positive Aging Consultations program improved access to geriatric care with minimal setup costs, but with limited uptake over a one-year period. Limitations of the program included low utilization, lack of longitudinal geriatric care, geriatrician shortage, and potential financial barriers. Disclosures Kristine M. Erlandson, MD MS, Gilead: Advisor/Consultant|Gilead: Grant/Research Support|ViiV: Advisor/Consultant