Background Patient non-adherence is one of the most threatening issues for the treatment effectiveness.1 A multidisciplinary approach, such as pharmaceutical care, should be applied to human immunodeficiency virus (HIV) patients. It should evaluate and identify the treatment options for each patient. The role of the clinical pharmacist is to optimise the treatment plan, patient adherence as well as detecting adverse drug reactions (ADRs), and so improving quality of life.
Purpose To compare the analytical evolution, ADRs and adherence of naive patients, with regimens of ‘multiples pills’ (RMP) versus fixed dose combinations (RFD).
Material and methods The study was a retrospective analysis of naive patients diagnosed and treated with antiretroviral drugs (ART) between June 2014 and June 2015, in which 5 naive patients were excluded. Variables studied were: prescribed ART, therapy start date, viral load and CD4 counts. This information was registered on an Excel file. The protocols were based on Portuguese guidelines.2
Monthly, each patient was questioned about ADRs; to evaluate adherence, we registered the date of ART delivery.
Results The study included 31 patients, 26 treated with RMP and 5 with RFD. We detected 11 ADRs; 73% of these were related to RMP and 1 patient needed to switch medication because of the ADR.
After 3 months of treatment, 55% of patients achieved undetectable viral load. Analysing the protocols, 12 patients given RMP obtained undetectable viral load versus 4 patients given RFD.
After 6 months of follow-up the results were inconclusive, but 68% of patients achieved adherence of up to 95%.
Regarding the average value for adherence, it was 92% in RMP patients versus 100% in RFD patients.
Conclusion Adherence and efficiency studies of RMP and RFD allow us to conclude that therapy simplification supports better clinical results. Our analysis makes clear that RFD has a beneficial impact on patients and compliance.
It must be borne in mind that a small universe and few sustainable results may undermine the hypothesis that fixed dose drugs improve tolerance in all aspects and increase life expectancy.
References and/or Acknowledgements
Andreia Carlos, et al. Diagnóstico da Infecção VIH–o que mudou em 10 anos. Revista da Sociedade Portuguesa de Medicina Interna 2015
Recomendações Portuguesas para o tratamento do VIH-1 e VIH-2, versão 1.0,2015
References and/or AcknowledgementsNo conflict of interest.
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