The Effectiveness of a Pharmaceutical Care Model on Adherence to Antiretroviral Therapy: A SAME-Based Cohort Study in Brazil

Abstract

Purpose: To verify the effectiveness of a pharmaceutical care model developed by the Specialized Municipal Assistance Service in Sorocaba, Brazil, on adherence to ART among patients infected with HIV. Methods: A cohort study compared adherence to ART in two groups of patients: intervention group (patients assisted with pharmaceutical care, n=130) and non-intervention group (patients attended by the habitual dispensing process, n=229). Antiretroviral adherence was measured by the number of pharmacy refill records in a six-month period. The relationship between the use of other drugs for the treatment of opportunistic infections and the adherence rate in the intervention group and the correlation between adherence and viral load and CD4 lymphocytes were also assessed. Results: Higher adherence rates were observed in the intervention group (p<0.05). The use of others drugs did not influence adherence to ART (p=0.30). There was a positive correlation between adherence and the percentage of patients in the intervention group with undetectable viral loads (p=0.0004) and higher levels of CD4 lymphocytes (p=0.0024). Conclusion: The pharmaceutical care model developed by the SAME improved patient adherence to ART as well as clinical outcomes.

Keywords

• Adherence rates
• Antiretroviral agents
• Maintenance of antiretroviral therapy
• Medication adherence
• Pharmaceutical care