The impact of HIV clinical pharmacists on HIV treatment outcomes: A systematic review

Department of Medicine, University of California, San Francisco, CA, USA.
Patient Preference and Adherence (Impact Factor: 1.68). 04/2012; 6:297-322. DOI: 10.2147/PPA.S30244
Source: PubMed


Due to the rapid proliferation of human immunodeficiency virus (HIV) treatment options, there is a need for health care providers with knowledge of antiretroviral therapy intricacies. In a HIV multidisciplinary care team, the HIV pharmacist is well-equipped to provide this expertise. We conducted a systematic review to assess the impact of HIV pharmacists on HIV clinical outcomes.
We searched six electronic databases from January 1, 1980 to June 1, 2011 and included all quantitative studies that examined pharmacist's roles in the clinical care of HIV-positive adults. Primary outcomes were antiretroviral adherence, viral load, and CD(4) (+) cell count and secondary outcomes included health care utilization parameters, antiretroviral modifications, and other descriptive variables.
Thirty-two publications were included. Despite methodological limitation, the involvement of HIV pharmacists was associated with statistically significant adherence improvements and positive impact on viral suppression in the majority of studies.
This systematic review provides evidence of the beneficial impact of HIV pharmacists on HIV treatment outcomes and offers suggestions for future research.

Download full-text


Available from: Mallory O'Neill Johnson,
  • [Show abstract] [Hide abstract]
    ABSTRACT: The efficacy of HIV pre-exposure prophylaxis (PrEP) has been demonstrated in four clinical trials to date; however, the success of PrEP is largely dependent on high levels of medication adherence. Due to their extensive experience and expertise in medication adherence counseling, as well as their ability to monitor and manage medication adverse effects and drug-drug interactions, clinical pharmacists are well-equipped to play a key role in effective PrEP utilization. Here we discuss reasons favoring the establishment of a protocol-based, pharmacist-run PrEP clinic.
    10/2012; 34(6). DOI:10.1007/s11096-012-9709-0
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives This paper describes the self-evaluation and peer review of the practice of a group of self-selected pharmacist prescribers managing patients with HIV-1 infection in secondary care settings in the UK. Methods Pharmacist prescribers who were responsible for managing an episode of care for adult HIV patients within defined clinical settings were invited to participate. The project lead worked with the volunteers to define, pilot and use a data collection tool for prospective data collection. Results Four pharmacist prescribers agreed to participate and a tool was developed and used for prospective data collection over 6months for a total of 95 patient consultations. The pharmacists were providing a number of different models of service delivery as either scheduled or unscheduled appointments, face-to-face or on the telephone. The primary purpose of the consultations ranged from initiation and optimisation of therapy to maintenance of supply of medicines and adherence advice. An attempt was made to look at patient outcomes in terms of viral load, and prescribing error rate was 1.2% of prescribed items. Conclusions This evaluation suggests that pharmacist prescribers are able to safely and effectively manage episodes of care for patients with HIV-1 infection. Use of the data collection tool was found to be relatively simple and could be used for routine self-assessment or further study. Limitations include the small size and the self-assessment by practitioners. Further work should focus on an evaluation of the service against the BHIVA Standards 2013 and the patient experience.
    European Journal of Hospital Pharmacy 01/2013; 21(1):13-17. DOI:10.1136/ejhpharm-2013-000305 · 0.43 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Pharmacists are now receiving reimbursement by the Ontario government to do medication reviews for patients on 3 or more medications. However, they are often too busy in the community setting to thoroughly review medications with patients. Having a designated pharmacist to provide medication reviews could increase the number of reviews performed. Step 1 involved developing a business plan to determine the number of medication reviews that needed to be done to pay a pharmacist a full-time salary. Step 2 involved establishing the core elements of medication therapy management that included medication review, a medication-related action plan, documentation and follow-up. In step 3, eligible patients were called and invited to attend an appointment to review their medications with the pharmacist. Upon completion of the medication reviews, a random group of patients were requested to complete a satisfaction survey after the medication review. Three hundred thirty-six patients received billable medication reviews from April 4 to July 27, 2012. Twenty-seven additional visits were performed as follow-up visits. Eighty pharmaceutical opinions met the eligibility criteria for billing. Fifteen patients received counselling for smoking cessation. Medication reviews were completed for 19 patients from 8 other pharmacies. Extra revenue was generated through the sales of replacements of expired products. An average of 2.08 drug-related problems per patients was identified. One hundred percent of the patients were very satisfied with the service. A full-time pharmacist position providing enhanced medication management services generated enough income to pay for a full-time pharmacist's salary. The benefits to the patients were an increase in identification and resolution of drug-related problems, as well as an opportunity to receive disease state education and experience an improvement in disease states. Patients were extremely satisfied with the medication review process and the service provided to them. Can Pharm J 2013;146:162-168.
    Canadian Pharmacists Journal 05/2013; 146(3):162-8. DOI:10.1177/1715163513481315
Show more