Clinical pharmacist input on HIV management may improve antiretroviral prescribing for psychiatric patients

Alice Margulis, Stepan Uhlyar, Nafeesa Chin-Beckford, Kailynn Deronde, Veronica Salazar, Lilian Abbo, Ana Vega

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The results of a study to determine the difference in HIV management with clinical pharmacist input in an adult psychiatric hospitalized patient population are reported. Methods: Single-center, retrospective study of patients admitted to a psychiatric hospital on antiretroviral (ARV) medication(s) from October 2016 to March 2017 (phase I: no pharmacist involvement), October 2017 to March 2018 (phase II: partial pharmacist involvement), and November 2018 to January 2019 (phase III: consistent pharmacist involvement). Patients were excluded if less than 18 years of age, pregnant, incarcerated, or taking ARV medication(s) for non-HIV indications. The primary outcome was difference in appropriateness of ARV therapy prior to and during pharmacist involvement. Secondary outcomes were appropriateness of opportunistic infection (OI) prophylaxis, laboratory testing, and comprehensive HIV management. Results: Thirty-seven patients were included per phase. An increased number of appropriate ARV regimens were initiated in phase II compared to phase I (62% vs 32%; P = 0.01) and in phase III compared to phase II (84% vs 62%; P = 0.036). Increased laboratory monitoring was seen with partial and consistent pharmacist involvement. Among the patients requiring OI prophylaxis, appropriate prophylaxis was initiated in more patients in phase III (57%) than in phase II (50%) or phase I (11%). More patients had comprehensive HIV management in phase II compared to phase I (38% vs 5%; P < 0.001) and in phase III compared to phase II (46% vs 38%; P = 0.48). Conclusion: Pharmacist involvement in HIV management in a psychiatric patient population increased appropriateness of ARV therapy, laboratory testing, and OI prophylaxis.

Original languageEnglish (US)
Pages (from-to)S10-S15
JournalAmerican Journal of Health-System Pharmacy
Volume78
DOIs
StatePublished - Mar 1 2021

Keywords

  • HIV
  • antiretroviral therapy
  • highly active
  • hospitals
  • mental disorders
  • pharmacists
  • psychiatric

ASJC Scopus subject areas

  • Pharmacy
  • Pharmacology
  • Health Policy

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