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Other Hospital Pharmacy topics (including: medical devices)
Assessing the impact of pharmaceutical interventions in tracking non-adherent HIV patients
  1. C. Mariño Martínez,
  2. M. González Martínez,
  3. S.E. García Ramos,
  4. M. Herrero Fernández,
  5. M. Fernández-Pacheco García-Valdecasas,
  6. R. Santolaya Perrín
  1. 1Hospital Princípe de Asturias, Pharmacy, Madrid, Spain

Abstract

Background Adherence in HIV patients is a basic factor in the effectiveness of the treatment. Pharmaceutical interventions may improve adherence.

Purpose To evaluate the effect of pharmaceutical interventions to enhance adherence (IEAs) on non-adherent HIV patients and to assess whether this improvement was maintained over time.

Materials and methods The authors retrospectively analysed the IEA carried out from January 2007 to September 2010, which were recorded in Farmatools software. IEAs (motivational interviews) were conducted when the patient didn't take the medication on time. The authors calculated the mean adherence 6 months before and 6 months after the date of IEA, using the repeat prescription records. The impact of the interventions was defined as the percentage of patients with adherence greater than 90 and 95% six months pre and postintervention. The variation of the percentage of adherence over time was also assessed (from 6 to 12 months post-intervention). SPSS 17.0 software was used.

Results 199 interventions were performed, 64 of which were excluded from analysis due to missing data (n=135). The mean adherences obtained 6 months pre and postintervention were 66.24% and 81.82% respectively (p<0.001).

The percentage of patients with adherence ≥95%:

  • Preintervention: 5.19% (7/135)

  • Postintervention: 20.74% (28/135).

  • ARR (adjusted relative risk) =15.55. NNT=7 (95% CI 5-13).

The percentage of patients with adherence ≥90%:

  • Preintervention: 6.67% (9/135)

  • Postintervention: 38.52% (52/135).

  • ARR=31.85 NNT=4 (95% CI 3-5).

Analysis of adherence modification (six and twelve months postintervention), showed that adherence decreased in 51.85% of cases, but the decrease was <5% in half of them.

Conclusions IEAs are an essential strategy to improve the adherence of HIV patients. The high increase of adherence postintervention and its persistence 12 months later shows the positive impact of this activity. Long-term studies are necessary to investigate the frequency of IEAs needed to maintain adequate adherence over time.

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