Pharmacist Intervention and Continued HIV Care: Examining the Connection

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In a 2-part study, a research team with Desert Regional Medical Center in Corona, CA is analyzing the need for pharmacist intervention for patients with HIV.

Could pharmacist-led medication reconciliation improve inpatient continuity of care in individuals with HIV? Researchers at a California medical center are seeking to find out.

In a 2-part study, a research team with Desert Regional Medical Center (DRMC) in Corona, CA is analyzing the need for pharmacist intervention for patients with HIV. The goal of the study is to ultimately find a way to improve continuity of care for these individuals at a higher rate than what the center currently sees.

“We have a lot of HIV-positive patients,” said primary author Vi Thai, PharmD, a PGY1 pharmacy resident at DRMC. "Thirty-eight percent did not continue the regimen when they could have."

Thai presented the study Wednesday in a poster session at the 2018 American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting in Anaheim, CA. She said medication adherence is extremely important to patients with HIV, since the virus can become drug-resistant when there are changes in the regimen.

According to researchers, there are more than 5,500 individuals with HIV/AIDS in DRMC’s Riverside County and more than half of those patients are residing in the Coachella Valley that the health system serves.

Researchers are utilizing retrospective medication reconciliation data of patients with HIV who were admitted to DRMC, from July 2017 through July 2018, to determine a possible need for pharmacist intervention. These patients are defined as having an International Classification of Diseases (ICD-10) diagnosis of HIV documented from their inpatient stay and were admitted from home, according to researchers.

According to an analysis of the retrospective data, Thai said, the researchers found that 38% of HIV-positive patients that had been admitted to DRMC were considered ‘fallouts.’ Another 51% of HIV-positive patients continued their regimens at home, and the remainder had provider support for not having a home regimen.

In an effort to increase the number of those continuing their medications at home, admittance of HIV-positive patients to the general medicine units at DRMC will trigger an automatic pharmacy consult, during the study period from November 2018 to March 2019. A pharmacy resident or a student trained in medication reconciliation will be tasked with gathering patient information through insurance claims, outpatient pharmacies, and patient or caregiver interviews.

Using this newly collected data, the researchers will compare the continued home use of HIV medication in the group who received pharmacist-led consultation compared with the retrospective group.

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