The Effect of Pharmacist Adherence Counseling and Goal Setting with HIV Patients within a Clinic Setting: A Retrospective Chart Review

Abstract

Background: Patients with a medication adherence rate of 80-90 % have the highest incidence of developing drug resistance Human Immunodeficiency Virus (HIV). The optimal adherence rate of 95% is believed to be necessary to prevent resistance to medication therapy in HIV infected patients. This level of adherence can be difficult to achieve because of the complications and complexity of medication regimens currently available for HIV treatment. Objectives: To determine if therapeutic goals set by the patient by having interventional meetings with a pharmacist improved their medication compliance rate and laboratory monitoring. Study Design: A retrospective chart review. Setting: One HIV clinic with two sites. Patients: The estimated population of the clinic was 150 patients. Only data from 14 patients met the criteria of the study and was available for collection. Intervention: Patients met initially with a pharmacist and made medication therapy goals. The patients then returned to the pharmacist at least once in a six-month period to evaluate if the goals were achieved. Measurements: CD4+ counts and viral loads from 6 months before the start of the intervention, at the beginning of intervention, and at least 6 months after the intervention were collected for analysis. Self-reports of achieving goals and self reported compliance were also collected. Results: The results showed there was no significant change in the CD+4 count in either the pre vs. baseline (p=0.0.967) or baseline vs. post- (p=0.551). There was also no significant change in the viral load in either the pre vs. baseline (p=0.388) or baseline vs. post (p=0.344). The mean (± SD) number of pharmacist visits was 2.93 (± 1.77). There was no significant improvement in viral loads (p=0.359) and CD4+ counts (p=0.268) between patient who reported missing medications and those who reported not missing doses. The same was true for patients who reported they met self-goals and those who reported they did not meet their goals (viral load p= 0.421 and CD4+ p=0.411). Conclusions: This study found no significant association between patients who set their own therapeutic goals and visited with a pharmacist and those who did not. However, an important limitation is that only 14 patients met the inclusion criteria for the study and had the required data available. Additional research is needed to more fully evaluate this intervention.