Impact of HIV-specialized pharmacies on adherence to medications for comorbid conditions

DuChane, Janeen; Clark, Bobby L.; Hou, John; Fitzner, Karen; Pietrandoni, Glen; Duncan, Ian

doi:10.1331/japha.2014.13165

Cited by 7 publications

(12 citation statements)

References 24 publications

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“…Pharmacy characteristics such as unprofessional staff and limited hours can discourage patients from refilling medications promptly [21]. However, special services such as home delivery and reminder calls can improve convenience for patients and facilitate adherence [38, 39]. Furthermore, provision of medication management by an HIV clinical pharmacist has been shown to improve adherence and clinical outcomes [40].…”

Section: Barriers and Facilitators To Retention And Adherencementioning

confidence: 99%

Retention in Care and Medication Adherence: Current Challenges to Antiretroviral Therapy Success

Holtzman

Brady

Yehia

2015

Drugs

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Health behaviors, such as retention in HIV medical care and adherence to antiretroviral therapy (ART), pose major challenges to reducing new HIV infections, addressing health disparities, and improving health outcomes. Andersen's Behavioral Model of Health Service Use provides a conceptual framework for understanding how patient and environmental factors affect health behaviors and outcomes, which can inform the design of intervention strategies. Factors affecting retention and adherence among persons with HIV include patient predisposing factors (e.g. mental illness, substance abuse), patient enabling factors (e.g. social support, reminder strategies, medication characteristics, transportation, housing, insurance), and health care environment factors (e.g. pharmacy services, clinic experiences, provider characteristics). Evidence-based recommendations for improving retention and adherence include 1) systematic monitoring of clinic attendance and ART adherence; 2) use of peer or paraprofessional navigators to re-engage patients in care and help them remain in care; 3) optimization of ART regimens and pharmaceutical supply chain management systems 4) provision of reminder devices and tools; 5) general education and counseling; 6) engagement of peer, family, and community support groups; 7) case management; and 8) targeting patients with substance abuse and mental illness. Further research is needed on effective monitoring strategies and interventions that focus on improving retention and adherence, with specific attention to the health care environment.

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Section: Barriers and Facilitators To Retention And Adherencementioning

confidence: 99%

Retention in Care and Medication Adherence: Current Challenges to Antiretroviral Therapy Success

Holtzman

Brady

Yehia

2015

Drugs

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“…There is only one study that has determined secondary non-adherence to HAART and specific co-medications to treat cardiovascular diseases such as ACE inhibitor, angiotensin receptor blocker or statin 15. In this study, the rate of non-adherence ranged from 37.0% to 41.6%, considering a target adherence of a PDC of 80% or greater.…”

Section: Discussionmentioning

confidence: 99%

Predictors of primary non-adherence to concomitant chronic treatment in HIV-infected patients with antiretroviral therapy

et al. 2017

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ObjectivesTo identify the independent risk factors of primary non-adherence to chronic concomitant treatment in HIV-positive patients, and to measure primary and secondary non-adherence rates to chronic treatments, and secondary non-adherence to antiretroviral therapy and the prevalence of concomitant chronic diseases.MethodsWe conducted a retrospective study that included HIV-infected patients with antiretroviral treatmentwho attended the pharmaceutical care office between January and December 2012. The dependent variable was primary non-adherence to concomitant prescription drugs for chronic diseases. To know the predictors of concomitant primary non-adherence, we performed a univariate analysis and a multivariate binary logistic regression model to identify the independent predictors of primary non-adherence to co-medication.ResultsOut of 598 patients analysed, 333 patients had a new co-medication prescribed during the studied period. The number of comorbidities per patient was 2.3 and the patients were treated with an average of 3.4 drugs. The rates of primary and secondary non-adherence to co-medication were 8.4% and 44.4%, respectively. The co-occurrence of primary and secondary non-adherence was 24.9%. The number of comorbidities (p=0.001) and co-medications (p=0.001) was significantly higher in patients who had primary non-adherence to co-medication. Furthermore, there was a statistically significant relationship between primary non-adherence and patients treated with psychotropic drugs (p=0.03). The multivariate analysis showed the independent predictor of primary non-adherence to co-medication was the number of co-medications (p<0.001).ConclusionOne-third of new concomitant medications prescribed to HIV-positive patients were never filled from the pharmacy. The number of co-medications was identified as a predictor of primary non-adherence to chronic concomitant treatment in HIV-infected population.

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“…[18][19][20][21] Some community pharmacies have implemented specialized services including prescription delivery, refill reminders, medication therapy management (MTM) services, and insurance assistance to promote adherence for people on HIV treatment and prevention medications. [22][23][24][25][26][27][28][29][30] Additionally, some community pharmacies are staffed with pharmacists specially trained in HIV care. Communitybased pharmacists are well positioned to assist with HIV adherence and care because community pharmacies are often within five miles of 88.9% of Americans, they have frequent interactions with patients, and have easy access to prescription refill information.…”

Section: Introductionmentioning

confidence: 99%

“…These studies are all located in chain community pharmacies and used proportion of days covered (PDC) as the primary outcome of measure for adherence. [26][27][28] Murphy and colleagues from a large national pharmacy chain found patients using HIV-specialized pharmacies had a significantly greater mean and median PDC score. 27 Similar results were observed in the study by Cocohoba and colleagues where HIV-F pharmacy users were associated with improved adherence compared with traditional pharmacy users.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of adherence to antiretroviral medications in a supermarket‐based community pharmacy

Loi

Tran

Seung

et al. 2023

J Am Coll Clin Pharm

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IntroductionA critical aspect of human immunodeficiency virus (HIV) infection management and prevention is adherence to antiretroviral (ARV) medications. There are limited recent studies focused on the impact of community pharmacy interventions on ARV adherence; previous studies were conducted between 2004 and 2012 with more complicated regimens.ObjectivesThe primary objective was to compare the adherence rates for ARV medications for both HIV treatment and prevention in patients using HIV‐focused (HIV‐F) pharmacies compared with traditional (non‐HIV focused) pharmacies in a supermarket‐based community pharmacy. The secondary objectives were to determine which factors impact adherence rates as well as the demographic information of patients using HIV‐F pharmacies.MethodsThis was a retrospective study of de‐identified pharmacy dispensing data for patients filling ARV medications from October 2018 to July 2021 at a Safeway pharmacy in the Washington D.C., Maryland, and Virginia (DMV) area. Patients 18 years and older who had fill records at a Safeway pharmacy in the DMV area of at least two 30‐day supplies of ARV medication were included. For all eligible patients, medication adherence was measured by assessing the proportion of days covered (PDC).ResultsOf the 1496 patients who met the inclusion criteria, 971 patients used an HIV‐F pharmacy. Overall, patients were predominantly male (78.9%) with a median age of 44 years. The median PDC score of HIV‐F pharmacies was higher than traditional pharmacies, but the difference was not statistically significant (97.1% vs. 96.6%, respectively, p = 0.2).ConclusionPatients using this regional division supermarket‐based community pharmacy have a high PDC score regardless of pharmacy type. Use of newer ARV agents may have facilitated patients' adherence and diminished the potential benefit of utilizing HIV‐F pharmacies. Pharmacies currently providing specialized patient care for ARV medications may need to re‐evaluate how best to promote medication adherence.

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Impact of HIV-specialized pharmacies on adherence to medications for comorbid conditions

Cited by 7 publications

References 24 publications

Retention in Care and Medication Adherence: Current Challenges to Antiretroviral Therapy Success

Retention in Care and Medication Adherence: Current Challenges to Antiretroviral Therapy Success

Predictors of primary non-adherence to concomitant chronic treatment in HIV-infected patients with antiretroviral therapy

Evaluation of adherence to antiretroviral medications in a supermarket‐based community pharmacy

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