Clinical and Economic Effects of a Pharmacist-Administered Antiretroviral Therapy Adherence Clinic for Patients Living with HIV

Abstract

This work was supported in part by a research grant to Dilworth, Mercier, and Borrego from the American Society of Health-System Pharmacists Foundation. Klein and Pinkerton were supported in part by grants T32-MH19985 and P30-MH52776, respectively, from the National Institute of Mental Health. No funding bodies had any role in the study design, data collection, analysis, decision to publish, or preparation of the manuscript. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Health Resources and Services Administration. The authors have no conflicts of interest to disclose. Study concept and design were contributed primarily by Dilworth, Mercier, and Borrego, along with the other authors. Dilworth took the lead in data collection, along with Pinkerton, Klein, Mercier, and Jakeman. Data interpretation was performed by Dilworth and Pinkerton, along with the other authors. The manuscript was written by Dilworth, Klein, and Jakeman, with assistance from the other authors, and revised by Dilworth, Jakeman, and Klein, with assistance from the other authors. The results from this study were presented in part at the 2015 United States Conference on AIDS in Washington, DC, on September 10-13, 2015.

Characterization of clinical pharmacy services in a pediatric HIV clinic

“…Collaboration with the family, education of the patient and caregiver, and offering of various technology tools (all strategies that were utilized in our study) were outlined as ways that pharmacists can be involved with improving pediatric medication adherence. More specific to HIV management, Horberg et al and Dilworth et al, describe improvement in antiretroviral adherence when clinical pharmacists were involved with care. In the Horberg study, the authors sought to find which multidisciplinary team member was most associated with improved antiretroviral adherence compared with a provider specialist alone .…”

“…It also demonstrates the sustained value of services provided by clinical pharmacists. Although medication management of HIV has evolved to include many once daily formulations, which in and of itself enhances adherence, clinical pharmacists still play an important role within HIV services as demonstrated in recent papers describing clinical pharmacy services in adult HIV patients . In more recent years, the population of pediatric HIV patients has aged and includes fewer infants and young children and more adolescents.…”

“…This In one study, 9 antiretroviral stewardship in pediatric HIV patients showed a positive impact on viral load and CD4 counts. and Dilworth et al, 12 describe improvement in antiretroviral adherence when clinical pharmacists were involved with care. In the Horberg study, the authors sought to find which multidisciplinary team member was most associated with improved antiretroviral adherence compared with a provider specialist alone.…”

“…Dilworth et al reported on the positive economic impact of a pharmacist-led antiretroviral adherence clinic; the savings outweighed the costs of the pharmacist-run clinic. 12 Although both of these studies were performed in adults, pharmacists enhancing adherence can be easily extrapolated to pediatric patients and our study describes some of the activities and interventions that were performed to enhance adherence.…”

Pharmacist impact on the HIV Care Continuum: Decreasing time to care

“…Previously published data on pharmacist involvement in the HIV Care Continuum tends to focus solely on the steps involving ART, not the earlier steps relating to linkage to care. Several studies have demonstrated the efficacy of pharmacists on increasing adherence to ARTs and therefore increasing viral suppression . Pharmacists at the Tennessee Valley Veterans Administration Medical Center recently reported the results of a pilot study introducing an HIV pharmacotherapy clinic.…”