TY - JOUR
T1 - Clinical pharmacist input on HIV management may improve antiretroviral prescribing for psychiatric patients
AU - Margulis, Alice
AU - Uhlyar, Stepan
AU - Chin-Beckford, Nafeesa
AU - Deronde, Kailynn
AU - Salazar, Veronica
AU - Abbo, Lilian
AU - Vega, Ana
N1 - Publisher Copyright:
© 2020 American Society of Health-System Pharmacists 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - 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.
AB - 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.
KW - HIV
KW - antiretroviral therapy
KW - highly active
KW - hospitals
KW - mental disorders
KW - pharmacists
KW - psychiatric
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U2 - 10.1093/ajhp/zxaa310
DO - 10.1093/ajhp/zxaa310
M3 - Article
C2 - 33037816
AN - SCOPUS:85102214630
VL - 78
SP - S10-S15
JO - Bulletin. American Society of Hospital Pharmacists
JF - Bulletin. American Society of Hospital Pharmacists
SN - 1079-2082
ER -