Background Pharmaceutical care consultations specialising in viral diseases seem to benefit the therapeutic objective.
Purpose To analyse the frequency of changes in antiretroviral treatment regimens (ART) when the patient is able to consult a pharmacist specialising in viral diseases; to determine the causes and compare the results with available studies that do not include a consultation of this nature.
Materials and methods Prospective observational study. The patients included were monoinfected HIV + and co-infected HIV/HCV patients who had been followed up in an outpatient consultation of a hospital and who had changed their ART for any reason between January 2010 and September 2013. The following variables were collected: age, sex, ART before and after the change and cause of change (adverse effects, simplification, interactions, virological failure and others). Adverse effects were classified as: gastrointestinal, renal, metabolic, hepatic, related to the central nervous system (CNS), cardiovascular and others. Data collection was done through the outpatient database and medical record reviews. Annual frequency of change and frequency depending on the cause were calculated. The data obtained were compared with those described in Davidson et al.’s study (Antiviral Research 2010, 86:227–9) concerning non-specialist consultations.
Results A total of 538 ART regimens were changed, affecting 44% (n = 365) of patients. 79% were men with a mean age of 48 years. The annual rate of change was 18%. The main cause of change was adverse effects (45%) (mostly for gastrointestinal disorders (26%) and CNS disorders (21%)). This was followed by other causes (19%), simplicity (19%), virological failure (12%) and interactions (5%).
Conclusions The reasons for discontinuation of ART agree in order but not in magnitude with those indicated in the existing bibliography. Fewer changes due to adverse effects were found and more changes in the hope of treatment optimisation when a specialised consultation was possible. This was due to better pharmaceutical care and better communication between doctor and pharmacist.
No conflict of interest.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.