Dispensing of Specialist HIV Drugs in Community Pharmacies-Evaluation of Effects on Access and Satisfaction

• Published in: Revista portuguesa de farmacoterapia Vol. 11; no. Sup 1
• Main Authors: M Gouveia, AT Rodrigues, M Borges, J Costa, F Fiorentino, J Jesus, M Cary, J Guerreiro, P Heudtlass, S Costa, AV Carneiro
• Format: Journal Article
• Language: English
• Published: Formifarma, LDA 01.12.2019
• ISSN: 1647-354X

Background The prospect of chronic HIV patients obtaining their ART medication in community settings has considerable interest for health authorities. In Portugal, the Health Ministry promoted a pilot study randomizing the dispensing of ART therapy to hospital pharmacies and to community pharmacies in order to assess the impact of a transfer of dispensing from the current hospital setting. This study “piggy backs” on that pilot and uses data from patients randomized to community pharmacies. Objectives To evaluate the impacts of transferring the ART therapy from hospital to community pharmacies. Methods Observational, prospective cohort study of the patients in the pilot study randomized to community pharmacies who were invited to participate and followed for 6 months. Data were collected through the pharmacies’ software (demographics, drugs dispensed, and pharmacists’ interventions) and patients´ self‐reported questionnaires (QoL, satisfaction, adherence, travel and waiting times). Descriptive statistics characterize the participants, drug exposure, and pharmacist’s interventions and the analysis compares QoL, adherence, satisfaction, travel modes, travel times and waiting times between the two dispensing settings. Results 29 pharmacies recruited 43 patients with a mean age of 54 (SD 9.85), 72% male and 48% were unemployed. The most frequently dispensed drugs were Abacavir/Lamivudine, Ritonavir, and Emtricitabine/Tenofovir, 49%, 33% and 30% of the times, respectively. Patients reported a significant increase in satisfaction levels regarding waiting time, privacy, business hours and overall satisfaction (p < 0.05). Mean travel time decreased 74% from 46 (SD 28) to 12 (SD 16) minutes. 79% of the patients walked to the community pharmacy compared with the 37% that walked to the hospital. Waiting time was 11 minutes lower (p < 0.05). There were no impacts on the QoL and on self‐reported adherence. The clinical stability of all patients was maintained. A total of 235 pharmacist interventions were reported as a consequence of the identification of health and drug‐related problems, the most common being potential drug interactions. Conclusions The findings suggest that changing the dispense setting of ART therapy from the hospital to the community pharmacy will not have negative impacts on health gains, measured by QoL, adherence and clinical stability and it will positively impact on patient’s satisfaction levels and access times. Published in: 34th International Conference on Pharmacoepidemiology and Therapeutic Risk Management. 22 to 26 of August. Prague, Czech Republic