HIV Clinical Pharmacist Improved Medication Adherence, Lowered Viral Loads

ROCKVILLE, Md., Sept. 16, 2014 /PRNewswire-USNewswire/ -- A recent study conducted by a team of researchers from Kaiser Permanente's Mid-Atlantic Region found that the introduction of an HIV clinical pharmacist improved medication adherence, resulting in better health outcomes and lower costs for HIV positive patients.

The study states that non-adherence to antiretroviral therapy (ART) has been associated with virologic failure and poor outcomes for patients with human immunodeficiency virus (HIV). Therefore, adherence to ART is an important aspect of HIV care. The study incorporated an HIV clinical pharmacist into the care of HIV patients to help improve antiretroviral (ARV) adherence, improve pharmacy and prescription coordination, and to provide education for patients in Northern Virginia, Washington, DC; and Prince George's and Montgomery Counties.

"The purpose of this program was to determine whether the inclusion of a HIV pharmacist to a multidisciplinary team provided a positive impact on the care of HIV patients," said Michael Horberg, MD, executive director of research, Mid-Atlantic Permanente Research Institute. "The patient population selected was those that would benefit from HIV clinical pharmacist interventions such as antiretroviral education, side effect management and financial assistance coordination."

The team was comprised of one HIV clinical pharmacist, Infectious Disease physicians, Infection Disease nurses and Infectious Disease clinical assistants from selected medical centers and representatives from the Medical Financial Assistance department. 

From December 2012 to April 2014, 144 patients were enrolled in the program. Researchers captured HIV viral load data for 128 patients, which was 89% of total program population. The proportion of patients with undetectable viral load before enrollment was 32% compared to 77% of patients after program enrollment.

"The program showed an increased proportion of patients with undetectable viral load and improved CD4 counts after program enrollment," said Danielle F. Ciuffetelli, PharmD, Hepatology/HIV Clinical Pharmacy Specialist II, Kaiser Permanente of the Mid-Atlantic States. "Evidence shows viral suppression and high CD4 counts on ARV therapy prevent opportunistic infections and other HIV-associated comorbidities."

The researchers extrapolated the cost savings for one year, including factors such as medication costs, emergency department visits, inpatient and outpatient costs, and estimated total annual cost savings came to $233,499, which is a 10.5% decrease in annual cost for the 98 patients evaluated.

Before enrollment in the study, there were 41 patients with undetectable viral load, and 87 with a detectable viral load. After the enrollment in the study, there were 98 patients with undetectable viral loads, and just 18 with a detectable viral load.

"This program demonstrates a change in the thought process," said Dr. Ciuffetelli."Since the program implementation, we have changed the thought process on managing HIV patients with non-adherence or educational issues. A multidisciplinary team now provides support and helps patients overcome barriers to therapy."

About Kaiser Permanente of the Mid-Atlantic States
Kaiser Permanente of the Mid-Atlantic States region, headquartered in Rockville, Maryland, provides and coordinates complete health care services for more than 510,000 members through 29 medical centers in Maryland, Virginia, and Washington, D.C. Founded in 1980, Kaiser Permanente of the Mid-Atlantic States is a total health organization comprised of Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., and the Mid-Atlantic Permanente Medical Group, P.C., an independent medical group that features more than 1,000 physicians. Kaiser Permanente of the Mid-Atlantic States was ranked in the nation's 20 top commercial health plans and 10 top Medicare health plans — and the No. 1 Commercial and Medicare plan for Maryland, Virginia, and Washington, D.C. — by "NCQA Health Insurance Plan Rankings 2013-2014 Private." For more information about Kaiser Permanente of the Mid-Atlantic States, visit kp.org or follow us on Twitter, twitter.com/KPMidAtlantic.

SOURCE Kaiser Permanente of the Mid-Atlantic States