Objective: To identify medication therapy issues and resolutions and assess their relationship to antiretroviral therapy (ART) adherence among participants of the Patient-Centered HIV Care Model demonstration project.
Methods: Adult persons with HIV (PWH) in the United States were enrolled in the Patient-Centered HIV Care Model from August 2014 to September 2016. Pharmacists conducted regular medication therapy reviews and documented ART and non-ART issues and suggested resolutions. Adherence to ART was calculated using proportion of days covered (PDC), and the mean PDC by the number of ART issues was compared using a generalized linear model with linear trend estimation.
Results: The most common ART issue was adherence (57%). Adherence ART issues were resolved by adherence management (48%) or patient education (36%). Participants had a mean of 4.2 ART issues and 6.4 non-ART issues. PDC was 89% for those with 0 ART issues and 73% for those with ≥3 ART issues. Persons with 0 ART issues had an increase in adherence (+8%) in the postperiod, whereas those with ≥3 ART issues had a decrease in adherence (-6%) (P = 0.02) in the postperiod.
Conclusions: Identifying therapy issues could help pharmacists improve care for PWH. Because PWH are an aging population with an increased risk of comorbidities and polypharmacy, pharmacists and providers should collaborate to provide holistic, primary care solutions to address both the number and nature of therapy issues.
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