Pharmacists can manage HIV comorbid conditions, produce cost savings, reduce drug interactions, and expedite viral load suppression.
Interdisciplinary teams are commonplace in HIV care, but the inclusion of a pharmacist on these care teams is relatively rare compared with other disease states.
HIV-positive patients require complex regimens to reduce their risk of disease progression and transmission, and pharmacists can play an important role in helping these patients.
An article published ahead-of-print in the American Journal of Health-System Pharmacists indicates that incorporating pharmacists into outpatient HIV clinics improves continuity of care, medication counseling, and adherence.
The outpatient infectious disease clinic at Northwestern Medicine in Chicago assimilated pharmacy staff (pharmacists, students, and technicians) into its teams in April 2014 to provide continuity of care and improve patient follow-up. The study authors chose to work with this infectious disease clinic because its staff had worked closely with inpatient pharmacists and appreciated the value of pharmacists’ knowledge.
Pharmacy staff provided medication education, access assistance (eg, financial assistance programs and completion of prior authorization requests), and treatment monitoring. One interesting component of the project was the inclusion of pharmacy technicians. Northwest Medicine is expanding technician roles to use their skillsets, redistribute pharmacist workload, and increase the pharmacy’s direct patient contact.
Past studies have shown that pharmacists improve comorbid condition management, produce cost savings, reduce drug interactions, and expedite viral load suppression. The pharmacists at Northwestern Medicine targeted adherence by suggesting largely unknown tools (eg, pill-containing keychains) and discussing potential barriers.
Pharmacists had the ability to delay highly active antiretroviral therapy initiation if the patient wasn’t immediately ready to start because of factors such as psychosocial unpreparedness. The pharmacists also confirmed patient regimens during Northwestern Memorial Hospital admissions and discharges to minimize inadvertent omissions and drug interactions.
Bundling of pharmacy services into the outpatient clinic ensured prompt and accurate communications between providers. Consolidated services also avoided the inadvertent dispensing of out-of-date regimens during automatic refills.
The results of this study—which demonstrate the benefits of pharmacists’ prescription filling, medication counseling, and adherence monitoring—could encourage other outpatient infectious disease clinics to include pharmacists on the HIV care team.