Clinical Impact of the Capacity-Motivation-Opportunity Pharmacist-Led Intervention in People Living with HIV in Spain, 2019–2020

Abstract

Ramón Morillo-Verdugo,1 María de las Aguas Robustillo-Cortes,2 Andrés Navarro-Ruiz,3 Javier Sánchez-Rubio Ferrandez,4 Sergio Fernández Espínola,5 María Fernández-Pacheco García-Valdecasas,6 Manuel Vélez-Diaz-Pallares7 1Pharmacy Hospital Service, Hospital Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain; 2Pharmacy Hospital Service, Hospital Juan Ramón Jiménez, Huelva, Spain; 3Pharmacy Hospital Service, Hospital de Elche, Alicante, Spain; 4Pharmacy Hospital Service, Hospital de Getafe, Madrid, Spain; 5Pharmacy Hospital Service, Hospital Serranía de Ronda, Málaga, Spain; 6Pharmacy Hospital Service, Hospital Príncipe de Asturias, Madrid, Spain; 7Pharmacy Hospital Service, Hospital Ramón y Cajal, Madrid, SpainCorrespondence: Ramón Morillo-Verdugo, Pharmacy Hospital Service, Hospital Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain, Email [email protected]: People living with HIV (PLWH) have significantly enhanced their life expectancy. Consequently, age-associated comorbidities and related health conditions are increasingly found in PLWH complicating their clinical management.Objective: To determine the effect of the capacity-motivation-opportunity (CMO) structured pharmaceutical care intervention for improving clinical health-care results frequently associated to PLWH.Methods: Multicenter, prospective, pre-post intervention study evaluating the CMO pharmacist-led program in adult PLWH was conducted between September 2019 and September 2020 with six months of follow-up. The primary objective of this study was to determine differences in clinical outcomes (total cholesterol, triglycerides, HDL, blood pressure and glycosylated hemoglobin) and variation in the patient’s activation measure before and after the intervention.Results: A total of 61 patients were included, 72% were men with a median age of 53 years. After the implementation of the pharmacist-driven program, the percentage of patients with high levels of total cholesterol decreased significantly (18% to 4.9%; p < 0.001). Similarly, the prevalence of patients with high levels of triglycerides, HDL or with hypertension was significantly lower post intervention (13.1% to 6.6%, p < 0.001; 47.5% to 6.6%, p = 0.019 and 24% to 4%, p = 0.009, respectively). The number of patients who achieved the highest activation level increased from 69% to 77.6% (p < 0.001).Conclusion: The CMO program resulted in significantly better health outcomes during the six months following the pharmacist-led intervention as well as improved activation in PLWH.Keywords: pharmaceutical care, HIV, clinical outcomes

Keywords

• pharmaceutical care
• hiv
• clinical outcomes