Pharmaceutical interventions in antiretroviral therapy: systematic review and meta-analysis of randomized clinical trials

Abstract

The results suggest that pharmaceutical interventions might contribute to improved adherence to ART and the achievement of virologic suppression, although the differences between the intervention and control groups were not statistically significant. Pharmaceutical interventions might be more efficacious in populations with low adherence to treatment and greater vulnerability.

Effect of a Structured Pharmaceutical Care Intervention Versus Usual Care on Cardiovascular Risk in HIV Patients on Antiretroviral Therapy: INFAMERICA Study

“…These outcomes include ART adherence, viral load suppression, reductions in the use of medical resources (hospitalization, doctor's visits, number of hospital days, visits to the emergency department), and pill burden and inappropriate discontinuation of outpatient medications as well as improved inpatient documentation of medication at home and accuracy of ART dosing. 9 The traditional pharmaceutical care model includes a large number of recommendations by pharmacists, which have typically been accepted by the doctor or health care team. Traditional standard of care for HIV patients was based on providing pharmaceutical care at the beginnings or at treatment discontinuation, the identification of drugrelated problem, and the enhancement of adherence.…”

“…These outcomes include ART adherence, viral load suppression, reductions in the use of medical resources (hospitalization, doctor’s visits, number of hospital days, visits to the emergency department), and pill burden and inappropriate discontinuation of outpatient medications as well as improved inpatient documentation of medication at home and accuracy of ART dosing. 9…”

“…8 The role of pharmacists as part of the multidisciplinary team that provides health care to HIV-infected patients and pharmaceutical care has helped improve health outcomes in this group of patients over the years. 9 At the same time, pharmaceutical care has also evolved in recent times to adapt to the new circumstances and needs of this population. 10 A new innovative strategy has been developed, using an approach based on the stratification of patients according to their needs, in accordance with their pharmacotherapeutic objectives, and supported by motivational interviews and follow-up using the new technological tools available.…”

Pharmacist-led counselling intervention to improve antiretroviral drug adherence in Pakistan: a randomized controlled trial

“…Pharmacists and other health professionals have similar consultation approaches which tend to vary during follow up. Many studies have suggested that by incorporating pharmacist in the multidisciplinary care, adherence to ART can be improved and virological suppression achieved [ 20 ]. Additionally, pharmacist-led interventions also incur some cost savings in terms of ART adherence treatment [ 21 ].…”

A Pharmacist’s Role in the Individualization of Treatment of HIV Patients

“…A number of studies [146][147][148] have shown significant gains in the level of adherence and clinical response of patients participating in dedicated pharmaceutical care programs. Furthermore, a recent meta-analysis [161] that evaluated four randomized controlled trials indicated that improvements in ART adherence and treatment efficacy may be greater in populations with ini-tially lower adherence and greater vulnerability, when these patients participate in pharmaceutical care interventions. Considering this evidence, the implementation of pharmaceutical care programs that include adherence evaluation and long-term personalized care is essential to increasing adherence to ART and improving patient outcomes.…”