Outcomes beyond infection management in comprehensive Medication Management Services for people living with HIV
DOI:
https://doi.org/10.17765/2176-9206.2023v16n4.e11966Keywords:
Medication therapy management, Pharmaceutical services, HIV, Patient outcome assessmentAbstract
To assess the clinical outcomes of comprehensive medication management (CMM) services offered to people living with HIV (PLHIV) at a Brazilian Antiretroviral Medication Dispensing Unit. The study was divided into a cross-sectional stage (stage I), to evaluate associated factor with the identification of two or more drug therapy problems (DTP) in the initial assessment; and a quasi-experimental stage (stage II), conducted with a single group of PLHIV to evaluate clinical outcomes. A total of 52 PLHIV, with 60±11.3 years of age were followed up. In stage I, the presence of dyslipidemia (OR=5.38; 95%CI=1.61-17.97) and the use of seven or more medications (OR=4.28; 95% CI=1.32-13.88) were factors associated with the identification of DTP. In stage II, a significant difference was demonstrated between the initial and final values of systolic blood pressure, triglycerides, HIV viral load and CD4+T-cells count (p<0,05). The CMM service favored positive clinical outcomes.Downloads
References
1. Barros S, Vieira-da-Silva L. Antiretroviral combination therapy, national anti-Aids policy and transformations of the Aids Space in Brazil in the 1990s. Saúde Debate [internet]. 2017 Sep [acessed 2023 Ago]; 41:114-128. Doi:1590/0103-11042017S309
2. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Boletim Epidemiológico HIV/aids. [internet] 2022 [accessed 2023 June]. Available online: https://www.saude.go.gov.br/files/boletins/epidemiologicos/dstds/2020/BoletimHIVAIDS_2020.pdf. Acessed June 06, 2023.
3. Cabrera DM, Diaz MM, Grimshaw A, Salvatierra J, Garcia PJ, Hsieh E. Aging with HIV in Latin America and the Caribbean: a Systematic Review. Curr HIV/AIDS Rep. [internet] 2021 [accessed 2023 June];18(1):1-47. doi:10.1007/s11904-020-00538-7
4. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Protocolo Clínico e Diretrizes Terapêuticas para Manejo da Infecção pelo HIV em Adultos. [Internet] 2018 [accessed 2023 Mai]. Available online: http://biblioteca.cofen.gov.br/protocolo-clinico-e-diretrizes-terapeuticas-para-o-manejo-da-infeccao-pelo-hiv-em-adultos/.
5. Luz PM, Veloso VG, Grinsztejn B. The HIV epidemic in Latin America: accomplishments and challenges on treatment and prevention. [internet] Curr Opin HIV AIDS [accessed 2023 June]. 2019;14(5):366-373. doi:10.1097/COH.0000000000000564.
6. Santos SF, Almeida-Brasil CC, Costa JO, Reis EA, Cruz MA, Silveira MR, Ceccato MGB. Does switching from multiple to single-tablet regimen containing the same antiretroviral drugs improve adherence? A group-based trajectory modeling analysis. [internet] AIDS Care [accessed 2023 Mar]. 2020; 10:1268-1276.
7. Edelman EJ, Rentsch CT, Justice AC. Polypharmacy in HIV: recent insights and future directions. Curr Opin HIV AIDS. [internet] 2020 [accessed June 2023] ;15(2):126-133. doi:10.1097/COH.0000000000000608
8. Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice: the patient centered approach to medication management, 3rd ed.; McGraw-Hill Medical: New York, United States of America, 2012.
9. Ramalho-de-Oliveira D. Atenção farmacêutica: da filosofia ao serviço de gerenciamento da terapia medicamentosa, RCN Editora: São Paulo, Brazil, 2011.
10. Brajković A, Bićanić LA, Strgačić M, Orehovački H, Ramalho-de-Oliveira D, Mucalo I. The Impact of Pharmacist-Led Medication Management Services on the Quality of Life and Adverse Drug Reaction Occurrence. [internet] Pharmacy (Basel). [acessed 2023 Mar] 2022;10(5):102. doi:10.3390/pharmacy10050102
11. Brumel AR, Soliman AM, Carlson AM, Ramalho-de-Oliveira D. Optimal diabetes care outcomes following face-to-face medication therapy management services. [internet] Popul Health Manag. [accessed 2022 Mai] 2013; 16: 28-34.
12. Nascimento YA, Silva LD, Ramalho de Oliveira D. The Lived Experience of Patients Utilizing Second-Generation Direct-Acting Antiviral for Treatment of Chronic Hepatitis C Virus Infection: A Phenomenological Analysis. [internet] Int J Environ Res Public Health. [accessed 2023 Ago] 2022;19(19):12540. doi:10.3390/ijerph191912540
13. Mendonça SAM, Melo AC, Pereira GCC, Santos DMSS, Grossi, EB, Sousa MCV, Ramalho-de-Oliveira D, Soares AC. Clinical outcomes of medication therapy management services in primary health care. [internet] Braz J Pharm Sci. [accessed 2023 Ago] 2016; 52: 365-373. doi: doi.org/10.1590/S1984-82502016000300002
14. Neves CM, Nascimento MMG, Silva DAM, Ramalho-de-Oliveira, D. Clinical Results of Comprehensive Medication Management Services in Primary Care in Belo Horizonte. [internet] Pharmacy (Basel). [accessed 2023 Ago] 2019; 7(2):58. doi:10.3390/pharmacy7020058
15. Peters DH, Tran NT, Adam T. Implementation research in health: a practical guide. World Health Organization (WHO): Geneva, 2013 [accessed 20203 Mar]. Avaliable Online: https://apps.who.int/iris/bitstream/handle/10665/91758/9789241506212_eng.pdf.
16. Pinnock H, Barwick M, Carpenter CR. Standards for Reporting Implementation Studies (StaRI) Statement. [internet] BMJ Open [ accessed 2023 Oct] 2017; 7: e013318. doi: 10.1136/bmjopen-2016-013318
17. Instituto Brasileiro de Geografia e Estatística (IBGE). População – Projeção e estimativas da população do Brasil e das Unidades da Federação [accessed 2022 Set]. Available online: https://ibge.gov.br/apps/populacao/projecao/index.html.
18. Molino CGRC, Carnevale RC, Rodrigues AT, Moriel P, Mazzola PG. HIV pharmaceutical care in primary healthcare: Improvement in CD4 count and reduction in drug-related problems. [internet] Saudi Pharm J. [accessed 2022 Feb] 2017; 25: 724-733. doi: 10.1016/j.jsps.2016.11.004
19. Aderemi-Williams RI, Nduaguba SO, Akoji EM, Ogbo PU, Abah IO. Drug therapy problems identified among patients receiving antiretroviral treatment in a HIV clinic: a prospective study in North Central, Nigeria. [internet] Pan Afr Med J. 2021 [acessed em 2023 Mar]; 40:233. doi:10.11604/pamj.2021.40.233.28160
20. Castilho JL, Escuder MM, Veloso V, Gomes JO, Jayathilake K, Ribeiro S, Souza RA et al. Trends and predictors of non-communicable disease multimorbidity among adults living with HIV and receiving antiretroviral therapy in Brazil. [internet] J Int AIDS Soc. [acessed em 2023 Mar] 2019; 22 (1): e25233. doi: 10.1002/jia2.25233.
21. Sarma P, Cassidy R, Corlett S, Katusiime B. Ageing with HIV: Medicine Optimisation Challenges and Support Needs for Older People Living with HIV: A Systematic Review. [internet] Drugs Aging. 2021 [accessed 2023 Ago] 2023;40(3):179-240. doi:10.1007/s40266-022-01003-
22. Feinstein MJ, Hsue PY, Benjamin LA, Bloomfield GS, Currier JS, Freiberg M.S, Grinspoon SK et al. Characteristics, Prevention, and Management of Cardiovascular Disease in People Living With HIV: A Scientific Statement. [internet] American Heart Association Circulation. [accessed 2023 Ago] 2019; 140: e98–e124. doi: 10.1161/CIR.0000000000000695C
23. Allavena, C, Hanf M, Rey D, Duvivier C, BaniSadr F, Poizot-Martin I, Jacomet C et al. Antiretroviral exposure and comorbidities in an aging HIV-infected population: The challenge of geriatric patients. [internet] PLoS One. [accessed 2023 Jun] 2018; 13 (9): e0203895. doi: 10.1371/journal.pone.0203895
24. Dias BM, Ramalho-de-Oliveira D, Santos BD, Neves CM, Oliveira GCB, Silva DÁM, et al. Factors associated with the identification of drug therapy problems among older patients in Primary Health Care. [internet] Einstein (São Paulo) [acessed 2023 oct] 2022; 8(20):eAO6544. doi: 10.31744/einstein_journal/2022AO6544.
25. Resende NH, Miranda SS, Ceccato MGB, Haddad JPA, Reis AMM, Silva DI, Carvalho WS. Drug therapy problems for patients with tuberculosis and HIV/AIDS at a reference hospital. [internet] Einstein. [accessed 2021 Jan] 2019; 17(4): eAO4696. doi: 10.31744/einstein_journal/2019AO4696
26. Detoni KB, Oliveira IV, Nascimento MMG, Caux, TR, Alves MR, Ramalho-de-Oliveira D. Impact of a medication therapy management service on the clinical status of patients with chronic obstructive pulmonary disease. [internet] Int J Clin Pharm. [ accessed 2022 Oct] 2017; 39(1): 95–103. doi: 10.1007/s11096-016-0402-6L
27. Loyola-Filho AI, Firmo JOA, Mambrini JV, Peixoto SV, Souza-Júnior PRB, Andrade FB, Lima-Costa MF, Acúrcio FA. Cost-related underuse of medications in older adults: ELSI-Brazil. Rev Saúde Pública. 2018; 52(2): 1s-8s.
28. Costa JO, Ceccato MGB, Silveira MR, Bonolo, PF, Reis EA, Acúrcio FA. Effectiveness of antiretroviral therapy in the single-tablet regimen era. [internet] Rev Saúde Pública.[accessed 2022 Mai] 2018; 52: 8-13. Doi: /10.11606/S1518-8787.2018052000399
29. Santos BD, Nascimento MMG, Oliveira GCB, Nascimento YA, Mambrini JVM, Cid AS, et al. Clinical Impact of a Comprehensive Medication Management Service in Primary Health Care. [internet] J Pharm Pract. [accessed 2023 sep] 2021; 34(2): 265-271. Doi: 10.1177/089719001986630929.
30. Silva DAM, Mendonça SAM, Ramalho-de-Oliveira D, Chemello C. Clinical practice of pharmacists in family health support team. [internet] Trab Educ Saúde. [accessed 2022 Mai] 2018, 16, 659-682. Doi: 10.1590/1981-7746-sol00108
Downloads
Published
How to Cite
Issue
Section
License
A submissão de originais para a revista Saúde e Pesquisa implica na transferência da Carta Concessão de Direitos Autorais, pelos autores, dos direitos de publicação digital para a revista após serem informados do aceite de publicação.A Secretaria Editorial irá fornecer da um modelo de Carta de Concessão de Direitos Autorais, indicando o cumprimento integral de princípios éticos e legislação específica. Os direitos autorais dos artigos publicados nesta revista são de direito do autor, com direitos da revista sobre a primeira publicação. Os autores somente poderão utilizar os mesmos resultados em outras publicações, indicando claramente a revista Saúde e Pesquisa como o meio da publicação original. Em virtude de tratar-se de um periódico de acesso aberto, é permitido o uso gratuito dos artigos, principalmente em aplicações educacionais e científicas, desde que citada a fonte. A Saúde e Pesquisa adota a licença Creative Commons Attribution 4.0 International.
A revista se reserva o direito de efetuar, nos originais, alterações de ordem normativa, ortográfica e gramatical, com vistas a manter o padrão culto da língua e a credibilidade do veículo. Respeitará, no entanto, o estilo de escrever dos autores. Alterações, correções ou sugestões de ordem conceitual serão encaminhadas aos autores, quando necessário. Nesses casos, os artigos, depois de adequados, deverão ser submetidos a nova apreciação. As opiniões emitidas pelos autores dos artigos são de sua exclusiva responsabilidade.
