Pharmaceutical care and evaluation of adherence to antiretroviral therapy in people living with HIV/AIDS

Abstract

Highly Active Antiretroviral therapy (HAART) depends on optimal adherence to be effective. Pharmacotherapeutic follow-up can be used as a strategy for treatment fidelity. To provide pharmaceutical care for HAART patients, to assess adherence, to identify and resolve drug related problems (DRP). This is a prospective, interventional study aimed at people on HAART. Data was collected using the pharmacotherapeutic follow-up form and CEAT-VIH. There was a predominance of women (59.1%), older than 33 years (75%), mostly single (43,2%). Regarding adherence, (63.6%) had insufficient adherence at the start of the study, while (36.4%) had strict/ adequate adherence. After the pharmacotherapeutic follow-up, (70,4%) presented strict/adequate adherence. Regarding HAART, the relationship between adherence versus time of HAART and adherence versus regimen used was significant, considering that less time of therapy and regimen containing protease inhibitors are predictors for insufficient adherence. Regarding the DRP identified (f=77), missed pills (32.4%), untreated disease, incorrect management frequency, and undue self-medication (11.7%) were the most frequent. Pharmaceutical interventions (f=137) were predominantly advising related to specific pharmacological treatment (32.1%), nonpharmacological measures (19.7%), and medication suspension (8.7%). Pharmaceutical care was shown to be animportant strategy, within the multi professional team, to improve adherence, besides identifying and resolving DRP.

Assessment of pharmaceutical care services provided to HIV infected patients on antiretroviral therapy in Rivers state, Nigeria

“…Documentation is a vital aspect of PC which is required for continuity of care, research reimbursement and evidence of action taken 12 . Most pharmacists in the study reported identifying drug therapy problems and followed up with suitable interventions which is similar to a study in Brazil by Schoenherr et al in which PC services were carried out with corresponding interventions 18 . However, only few respondents in this study documented drug therapy problems and their corresponding interventions.…”

“…Inter-professional team collaboration is when several health workers from various professional backgrounds provide comprehensive services by working with patients, their families, carers and communities to achieve the highest quality of care 24 .Research shows that when inter-professional team practice collaboratively, patient-centred care is enhanced and there is an improvement in patient and health systems outcomes [25][26] . Pharmacists have the ability to assess patients with virologic failure, evaluate reasons for failure such as non-adherence to ART and provide education on new antiretroviral regimens, thus they are an integral part of the multidisciplinary management of HIV positive patients 18 . Pharmacists have the ability to contribute to every component of HIV care.…”