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Impact and acceptance of pharmacist-led interventions during HIV care in a third-level hospital in Spain using the Capacity-Motivation-Opportunity pharmaceutical care model: the IRAFE study
  1. M Gracia Cantillana-Suárez1,
  2. Maria de las Aguas Robustillo-Cortés2,
  3. Antonio Gutiérrez-Pizarraya3,
  4. Ramón Morillo-Verdugo3
  1. 1Pharmacy, Hospital Universitario de Cáceres, Cáceres, Spain
  2. 2Pharmacy, Hospital Juan Ramón Jiménez, Huelva, Andalucía, Spain
  3. 3Pharmacy, Hospital Universitario Virgen de Valme, Sevilla, Spain
  1. Correspondence to Dr Antonio Gutiérrez-Pizarraya, Pharmacy, Hospital Universitario Virgen de Valme, 41014 Sevilla, Spain; boticariors{at}gmail.com

Abstract

Introduction In recent decades, HIV has become a chronic disease with which the HIV specialist pharmacist plays a fundamental role. The traditional pharmaceutical care model followed to date relied excessively on the medication, obviating the uniqueness of each patient. The purpose of this study was to determine the influence and acceptance of a Capacity-Motivation-Opportunity (CMO)-based structured pharmaceutical care (PC) intervention in a multidisciplinary team for improving healthcare results.

Methods Prospective single-centre study of a structured health intervention with patients living with HIV who attended hospital between January 2017 and June 2018 for any cause. Pharmacotherapeutic follow-up was applied according to the CMO PC model based on three key elements, namely stratification, motivational interview and new technologies. To assess differences in the variables collected before and after the intervention, Student's t-test or Wilcoxon test, and McNemar’s test were used for quantitative and dichotomous variables, respectively.

Results A total of 349 patients were included, 76.1% of which were men. The acceptance of pharmacist intervention by both doctors and patients was high [336 (97.7%) and 321 (93.3%)] and the adherence rate to antiretroviral therapy before intervention was lower than that observed afterwards (85.6%±33.7% vs 96.4%±17.7%; p<0.001). No differences were found between median viral load pre- versus post-intervention [1175 (62.75–26 050) copies/mL vs 274 (76.75–5542) copies/mL], although the undetectability rate was recorded as higher after intervention compared with the previous period [294 (85.5%) vs 274 (79.7%); p<0.001].

Conclusions Our results could help HIV pharmacy clinic specialists to recognise high-risk patients and to develop personalised follow-up care, thereby ensuring good adherence and response to treatments.

  • clinical pharmacy
  • health services administration & management
  • HIV & AIDS
  • medical education & training
  • pharmacy management (organisation
  • financial)
  • HIV

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