A LONGITUDINAL STUDY OF PATIENT ADHERENCE TO ANTIRETROVIRAL THERAPY AT THE CASSIANO ANTONIO DE MORAES UNIVERSITY HOSPITAL DRUG DISPENSING UNIT: PHARMACEUTICAL STRATEGIES AMONG PEOPLE LIVING WITH HIV/AIDS.
Name: PATRÍCIA DE OLIVEIRA FRANCA
Publication date: 29/03/2022
Advisor:
Name |
Role |
|---|---|
| CRISPIM CERUTTI JUNIOR | Advisor * |
Examining board:
| Name |
Role |
|---|---|
| CARLOS GRAEFF TEIXEIRA | Internal Examiner * |
| CRISPIM CERUTTI JUNIOR | Advisor * |
| LAURO FERREIRA DA SILVA PINTO NETO | External Examiner * |
| MOISES PALACI | Internal Examiner * |
| RITA DE CÁSSIA RIBEIRO GONÇALVES | External Examiner * |
Summary: To achieve the benefits of antiretroviral therapy (ART) and ensure infection control, it is of utmost importance that patients maintain a degree of adherence to therapy higher than 90%. Thus, the aim of this study was to carry out an epidemiological investigation of the adherence process of HIV/AIDS patients starting ART in 2017. We conducted a longitudinal prospective, quasiexperimental study to evaluate the rate of adherence to ART during a pharmaceutical intervention in the Medication Dispensing Unit of a University Hospital in Vitória, Espírito Santo. The sample consisted of 109 patients who met the predetermined inclusion criteria. It was found that 76.1% of the population was male, 46.8% were brown, 80.7% were single, 33.9% had 12 or more years of schooling, 42.2% were heterosexual, 61.5% used alcohol, 21.1% used drugs and 39.4% were smokers. The average age of patients was 34.7 years (SD = 12.4). Among them, 81.7% started treatment with more than 1000 viral copies/ml and 68.8% with TCD4+ lymphocyte count greater than 350 cells/mm3 . The adherence profile of patients in this study was calculated through medication dispensing profile in the pharmacy and by self-report. It was observed that the mean adherence rate was 93.25% and 93.31% at 12 and 24 months of follow-up. There were 992 sessions of pharmaceutical interventions, of which 43.6% were associated with patient education, 19.7% were related to drug interactions, and 14.4% corresponded to monitoring the patient`s clinical evolution. Of all participants, after 24 months of follow-up, 80.8% of them were adherent. We found an association between sociodemographic, behavioural, social and clinical variables and adherence, and identified as the main factors that contributed to non-adherence the illicit drug use [adjusted odds ratio (ajOR=3.9), 95% confidence interval (95% CI= 1.09-13.98) (p= 0.037)], and the difficulty to access to the medicines [ajOR=3.7, 95% CI= 1.15-11.64 (p= 0.028)]. Pharmaceutical counselling played an important role in all interventions, increasing medication adherence.
