Magazine article Drug Topics

How Pharmacists Can Help HIV Patients Comply Better

Magazine article Drug Topics

How Pharmacists Can Help HIV Patients Comply Better

Article excerpt

Pharmacists can help HIV patients stick with medication schedules by educating them about the importance of consistency, said experts at the Current Issues in HIV Therapeutics seminar. The seminar was held in Orlando, Fla., in conjunction with the International Congress on Clinical Pharmacy.

"Patient education is the keywe must use data from adherence studies when talking to patients," said Michael Postelnick, infectiousdiseases pharmacist at Northwestern Memorial Hospital in Chicago.

Adherence is a problem among HIV patients because they skip pills to avoid side effects, find the instructions hard to follow, or get busy and forget to carry their pills, according to Margaret Chesney, codirector of the Center for AIDS Prevention Studies at the University of California-San Francisco.

In a study by Chesney and other researchers in 1997, 36% of patients said they had missed doses of their medication "in the past two weeks." In another study, done at San Francisco General Hospital, 43% of the patients said they "forgot" to take medications, while 36% said they were asleep when they were supposed to take medications, 32% were away from home, and 22% were "too busy." In addition, 9% didn't take medication because they were depressed.

The patients more likely to adhere to their therapies are white men with health insurance who are not substance abusers and those who perceive that antiretrovirals are effective and who are able to fit medications into their daily schedules, said Postelnick.

Pharmacists can share the importance of adherence through studies such as the one presented at the recent Conference on Retroviruses and Opportunistic Infections in Chicago, he continued. The study showed that patients who adhered to their HIV medication schedules 95% or more of the time were more likely to have a viral load less than 400 copies per ml. "Levels of adherence of 95% or greater are likely to be necessary for durable response," he said.

And in a 1998 study, HIV patients who adhered to their medication schedule increased the likelihood of maintaining their virus load suppression, according to Postelnick. When pharmacists share these success stories and other information with patients, the patients are more likely to stick to their schedules, he said. …

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