Objective To demonstrate that a pharmacist-managed medication adherence program can increase medication adherence in the treatment of HIV-infected women, adolescents, and children resulting in improvement of their immunological and virologic markers.
Methods A retrospective review was conducted of HIV-infected women, adolescents, and children who attended the Family Specialty Clinic from January 2003 through December 2004. The study cohort included patients who received medication adherence counseling from January through December 2004. This group of patients was then compared with patients who were stable on their antiretroviral regimen the year prior to initiation of the medication adherence counseling program (those seen at the clinic from January through December 2003). Epidemiological and laboratory data, including HIV-1 RNA (viral load) and CD4+ T cell counts, were also collected.
Results Forty patients were eligible and included in the study. Majority of the patients were female (80%), mainly African American (90%), and most of these women (30%) were between 20 and 29 years of age. A total of 72 medication adherence interventions occurred during the study period. Mean medication adherence interventions by clinical pharmacists occurred 1.8 times. There was a small but not statistically significant improvement between mean viral load and CD4+ T cell count of patients at baseline (16,464 copies/mL and 646 cells/mm3) compared to after medication adherence intervention (14,218 copies/mL and 617 cells/mm3, p = .84 and .39). There were 35 clinic appointments missed at baseline compared to 48 missed visits after medication adherence interventions (p = .15).
Conclusion We therefore conclude that our medication adherence program initiated over a period of 1 year did not demonstrate a statistically significant difference in immunological and virologic outcome. However, further study over a longer time interval may be necessary to determine benefit of a medication adherence program in the treatment of HIV-infected women, adolescents, and children.
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