Pharmacist HIV Treatment Beats Primary Care Alone

Pharmacist management of human immunodeficiency virus (HIV) produces earlier viral suppression in treatment-naïve patients than primary care alone.

To determine the impact of pharmacist pharmacotherapy management for HIV patients, a team of HIV pharmacist specialists retrospectively examined antiretroviral therapy (ART) outcomes in treatment-naïve patients who began ART at an HIV clinic.

The participants were enrolled between 1999 and 2013, and they were classified into 2 groups: intervention patients referred to a clinic-based HIV pharmacist for ART initiation (n=819) and control subjects receiving ART only from a primary care provider (n=436).

The researchers compared the groups’ time to viral suppression and first treatment regimen change.

During the first 2 years following treatment initiation, HIV patients receiving ART managed by pharmacists achieved viral suppression 1.41 times faster than the control subjects.

Therefore, the authors wrote, “In treatment-naïve patients, suppression of HIV viral load occurred earlier when pharmacists assisted with initiating ART than when ART was initiated without that assistance.”

HIV patients receiving pharmacist management services also reported more frequent monitoring within the first 6 months of ART, providing more opportunities for patient education about the importance of treatment adherence, goals, and related adverse effects, the authors said.

Additionally, the median time to the first treatment regimen change was 100 months among the pharmacist intervention participants, compared with 44 months among the control subjects. This lengthier adherence in the intervention group may be attributed to pharmacists initially selecting more potent or better-tolerated regimens and providing intensive adherence counseling, the authors hypothesized.

“In combating HIV, adherence to ART therapy can dramatically prolong the lives of infected individuals and lower their chance of infecting others,” stated lead study author Ofir Noah Nevo, PharmD, in a press release. “Our results validate that pharmacist activities help optimize patient outcomes and provide an example of successful long term use of a recently described model of care.”