Background Adherence to antiretroviral treatment can prevent virological failure in HIV patients. Pharmaceutical intervention in these patients is important and it is a key point to increase adherence to treatment.
Purpose Analysis of the impact of a pharmaceutical care (PC) program on the evolution of adherence to antiretroviral treatment (ART).
Materials and methods A descriptive and interventionist study on the adherence of HIV patients to ART through the analysis of each patient’s dispensing records throughout 2007–2012, obtained from the external patient management program Dipex®v2.6. and APD-ATHOS prisma®. The PC program consisted in: 1)creating adherence reports, sent daily to each doctor, of patients consulted with the following variables: current ART, adherence, pharmaceutical observations, doctor’s commentary and compliance, viral load and CD4. This adherence report is returned to our unit, becoming a feed-back tool of all information between the doctor and pharmacist; 2)selecting patients with incidents in their adherence; 3)interviewing patients with bad evolution in their adherence during the last 6 months.% Adherence is calculated = number of dosage units dispensed/number of dosage units planned for a period of six months. Good adherence was defined as >95%,irregular adherence 85–94%,poor adherence <85%.
Results 635 patients received ART during the study period. There were 4802 reports in total (2 reports/patient/year). Patients with good adherence went from 57.4% in 2007 to 73.8% in 2012, displaying an increase of 16.4% and an average of 66.46% ± 8.2. The rate of patients with irregular adherence went from 17.3% at the start of the study period to 8.05% at the end, resulting in a decrease of 9.25% in adherence to ART and an average during the period of 12,3% ± 3,42. The initial percentage of patients with poor adherence was 17.6% vs. 8.62% in the last year, representing a decrease of 8.98%. Poor adherence had an average of 13.67% ± 2.42. The average percentage of patients whose adherence worsened during the study period was 9.7% ± 3.48%. 36.88% ± 8.83 of patients improved their adherence (to irregular or good) to ART.
Conclusions The PC program has helped improve the rate of ART adherence. Joint assessment of adherence in real time by different professionals through reports and clinical interviews, allow us to determine more exactly the compliance of ART and thus detect possible opportunities for better adherence by our patients.
No conflict of interest.
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