Drug therapy problems identified among patients receiving antiretroviral treatment in a HIV clinic: a prospective study in North Central, Nigeria

Abstract

Introduction: despite improved life expectancy for people living with HIV (PLWH), aging, comorbidities, and associated drug treatment increase the risk for drug therapy problems (DTPs). We assessed pharmacists´ identification and resolution of DTPs among PLWH. Methods: a prospective study was conducted among PLWH aged ≥10 years (N=100) in a Nigerian HIV clinic. Trained pharmacists delivered a six-step intervention that included the establishment of patient-provider relationship, gathering and validation of patient´s data, identification of DTPs, intervention, outcome identification, and documentation. Descriptive statistics were used to examine data collected via a pharmaceutical care assessment tool. Results: in all, 215 DTPs were identified and classified as unnecessary drug therapy [27.4% (n=59)], non-adherence [21.9% (n=47)], needs additional drug therapy [16.7% (n=36)], adverse drug reaction [(14.0% (n=30)], wrong drug [(10.7% (n=23)], and dosage variation [n=20 (9.3%)]. Within each DTP class, the most common cause was addiction/recreational drug use [39.0% (n=23)], drug product not available [63.8% (n=30)], untreated condition(s) [61.1% (n=22)], undesirable effects [66.7% (n=20)], condition refractory to drug [34.8% (n=8)], and drug interaction [45.0% (n=9)], respectively. The most common interventions were medication information/recommendation to patients/prescribers (30.4%) and initiation of drug therapy (22.2%). Six-month resolution rate was 90% (n=194) with the most common outcomes being improvement in patient adherence [23.6% (n=50)], addition of a drug [18.9% (n=40)], and reduction in drug overuse [15.6% (n=33)]. Conclusion: pharmacists´ intervention resulted in 90% resolution of detected DTPs, implying that pharmacists are crucial in improving antiretroviral treatment outcomes.

Global research trends and hotspots in pharmaceutical care: a bibliometric analysis and visualisation using CiteSpace and VOSviewer

“…Engagement of hospital and community pharmacists will help achieve seamless pharmaceutical care between primary and secondary care settings 47. Pharmaceutical care interventions provided by pharmacists can solve 90% of pharmacy-related problems 48. The participation of clinical pharmacists in the hospital drug policy of rural hospitals can optimise drug investment and save a lot of medical costs for the medical system 49…”

“…47 Pharmaceutical care interventions provided by pharmacists can solve 90% of pharmacy-related problems. 48 The participation of clinical pharmacists in the hospital drug policy of rural hospitals can optimise drug investment and save a lot of medical costs for the medical system. 49 It can also be seen from figures 5 and 6 that the popularity of the research topic clustering 4-16 is gradually decreasing, as is also the development process of the research topic from near to far over time-for example, a patient satisfaction questionnaire for outpatient pharmacy based on the assessment of feasibility and sustainability of pharmaceutical care provided (#4 ambulatory care pharmacy service), 50 formulating pharmaceutical care measures to solve problems related to drug treatment of inpatients in internal medicine (#5 drug-related morbidity), 51 pharmaceutical care intervention is crucial to establish a good medical relationship, and affects the treatment and care outcomes of the elderly 52 .…”