Pharmaceutical care and evaluation of adherence to antiretroviral therapy in people living with HIV/AIDS
DOI:
https://doi.org/10.1590/s2175-97902022e19613%20Keywords:
HIV infections, Anti-retroviral agents, Medication adherence, Pharmaceutical servicesAbstract
Highly Active Antiretroviral therapy (HAART) depends on optimal adherence to be effective. Pharmacotherapeutic follow-up can be used as a strategy for treatment fidelity. To provide pharmaceutical care for HAART patients, to assess adherence, to identify and resolve drug related problems (DRP). This is a prospective, interventional study aimed at people on HAART. Data was collected using the pharmacotherapeutic follow-up form and CEAT-VIH. There was a predominance of women (59%), older than 33 years (75%), mostly single (43%). Regarding adherence, 64% had insufficient adherence at the start of the study, while 36% had strict/adequate adherence. After the pharmacotherapeutic follow-up, 70% presented strict/adequate adherence. Regarding HAART, the relationship between adhesion versus time of HAART and adherence versus regimen used was significant, considering that less time of therapy and regimen containing protease inhibitors are predictors for insufficient adherence. Regarding the DRP identified (f=77), missed pills (32%), untreated disease, incorrect management frequency, and undue self-medication (12%) were the most frequent. Pharmaceutical interventions (f=137) were predominantly advising related to specific pharmacological treatment (32%), non-pharmacological measures (20%), and medication suspension (9%). Pharmaceutical care was shown to be animportant strategy, within the multi professional team, to improve adherence, besides identifying and resolving DRP.
Downloads
References
Brasil. Boletim Epidemiológico - HIV/AIDS. Ministério da Saúde. Brasília; 2016.
Brasil. Capacitação para implantação dos serviços de clínica farmacêutica/Ministério da Saúde, Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Assistência Farmacêutica e Insumos Estratégicos. Ministério da Saúde. Brasília; 2014. 308 p.: il.(Cuidado farmacêutico na atenção básica; caderno 2).
Brasil. Nota Informativa 007/2017 - DDAHV/SVS/MS. Ministério da Saúde. Brasília; 2017. Disponível em: Disponível em: http://azt.aids.gov.br/documentos/siclom_operacional/Nota%20Informativa%20007%20-%20protocolo%20de%20uso%20ARV%20-%202017.pdf Acesso em 09/08/2018.
Cancian NR, Beck ST, Santos GS, Bandeira D. Importância da Atenção Multidisciplinar para resgatar o paciente com HIV/AIDS apresentando baixa adesão ao tratamento Antirretroviral. Rev Atenção Saúde. 2015;13(45):55-60.
Correr CJ, Otuki MF, Soler O. Assistência farmacêutica integrada ao processo de cuidado em saúde: gestão clínica do medicamento. Rev Pan-Amaz Saude. 2011;2(3):41-49.
Costa JDM, Torres TS, Coelho LE, Luz PM. Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: Systematic review and meta-analysis. J Int AIDS Soc. 2018;21(1):01-20.
Dunbar-Jacob J, Mortimer-Stephens MK. Treatment adherence in chronic disease. J Clin Epidemiol. 2001;54(Suppl. 1):57-60.
Foresto JS, Melo ES, Costa CRB, Antonini M, Gir E, Reis RK. Adesão à terapêutica antirretroviral de pessoas vivendo com HIV/Aids em um município do interior paulista. Rev Gaúcha Enferm Porto Alegre. 2017;38(1):e63158.
Hernandez CD, Lucchwetta RC, Nadai TR, Galduróz JCF, Mastroianni PC. Self-perception of knowledge and adherence reflecting the effectiveness of antiretroviral therapy. Patient Prefer Adher. 2016;10:1787-1793.
Lemos LA, Fiuza MLT, Reis RK, Ferrer AC, Gir E, Galvão MTG. Adherence to antiretrovirals in people coinfected with the human immunodeficiency virus and tuberculosis. Rev Latino-Am Enfermagem. 2016;24:e2691.
Molino CGRC, Carnevale RC, Rodrigues AT, Visacri MB, Moriel P, Mazzola PG. Impact of pharmacist interventions on drug related problems and laboratory markers in outpacients whit human imunodeficiency virus infection. Ther Clin Risk Manage. 2014;10:631-639.
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. Saudi Pharm J. 2017;25(5):724-733.
Moraes DCA, Oliveira RC, Motta MCS, Ferreira OLC, Andrade MS. Terapia antirretroviral: a associação entre o conhecimento e a adesão. Rev Fund Care Online. 2015;7(4):3563-3573. DOI: 10.9789/2175-5361.2015.v7i4.3563-3573.
» https://doi.org/10.9789/2175-5361.2015.v7i4.3563-3573
Padilla HLE. Adherencia al tratamiento antirretrovial en los pacientes de la consulta de VIH del Iahula y su posible relación sobre el comportamiento de la epidemia del VIH/SIDA em el Edo. Mérida durante el quinquenio 2011-2015. 76f [Tese]. Curso de Postgrado de Medicina Interna, Universidad de Los Andes, Faculdad de Medicina. Mérida, Venezuela. p.54-59; 2016.
Paraná. Boletim Epidemiológico - HIV/AIDS. Secretaria de Estado da Saúde. Paraná; 2015. Disponível em http://www.saude.pr.gov.br/arquivos/File/boletimhivaids2015__1.pdf >. Acesso em: 06 nov 2018.
» http://www.saude.pr.gov.br/arquivos/File/boletimhivaids2015__1.pdf
Reis A, Guerra MP, Lencastre L. Treatment Adherence, Quality of Life and Clinical Variables in HIV/AIDS Infection. World J AIDS. 2013; 3(3):239-250.
Remor E, Milner-Moskovicsi J, Preussler G. Adaptação Brasileira do “Cuestionario para la Evaluación de la Adhesión al Tratamiento Antiretroviral”. Rev Saúde Pública. São Paulo. 2007;41(5):685-694.
Remor E. Self-reported adherence to antiretroviral therapy in HIV+ Colombian population. Sage open [Internet]. 2013a;3(3):1-7. Available from: < Available from: https://doi.org/10.1177/2158244013497727 >. Access on 25 jul 2018.
» https://doi.org/10.1177/2158244013497727
Remor E. Systematic Review of the Psychometric Properties of the Questionnaire to Evaluate the Adherence to HIV Therapy (CEAT-VIH). Patient. 2013b;6(2):61-73.
Remor E. Valoración de la adhesión al tratamiento antirretroviral en pacientes VIH+. Psicothema. 2002;14(3):262-267.
Remor, E. Release of an Online Self-Reporting Tool for Assessing Adherence to Antiretroviral Therapy (CEAT-VIH). J Antivirals Antiretrovirals. 2013c;5:178-179.
Remor, E. Adesão ao Tratamento Médico. In: Elisa Kern de Castro; Eduardo Remor. (Org.). Bases Teóricas da Psicologia da Saúde. 1ed.Curitiba: Editora Appris; 2018, p. 199-214.
Resende RC, Podesta MHMC, Souza WA, Barroso TO, Vilas Boas OMGC, Ferreira EB. Adesão ao tratamento antirretroviral de pacientes vivendo com HIV/AIDS atendidos pelo Sistema Único de Saúde. Rev Univ Vale do Rio Verde. 2012;10(2):186-201.
Saberi P, Dong BJ, Johnson MO, Greenblatt RM, Cocohoba JM. The impact of HIV clinical pharmacists on HIV treatment outcomes: a systematic review. Patient Prefer Adherence. 2012;6:297-322.
Salmanton-Garcia J, Herrador Z, Ruiz-Seco P, Nzang-Esono J, Bendomo V, Bashmakovic E, et al. Self-reported adherence to antiretroviral therapy in HIV+ population from Bata, Equatorial Guinea. AIDS Care. 2015;28(5):543-553.
Seidl EMF, Melchíades A, Farias V, Brito A. Pessoas vivendo com HIV/AIDS: variáveis associadas à adesão ao tratamento antirretroviral. Cad Saúde Pública Rio de Janeiro. 2007;23(10):2305-2316.
Silva RAR, Nelson ARC, Duarte FHS, Prado NCC, Rodrigo JRR. Avaliação da adesão à terapia antirretroviral em pacientes com Aids. Rev Fund Care Online . 2017;9(1):15-20. DOI: http://dx.doi.org/10.9789/2175-5361.2017.v9i1.15-20
» http://dx.doi.org/10.9789/2175-5361.2017.v9i1.15-20
Simoni JM, Frick PA, Pantalone DW, Turner BJ. Antiretroviral adherence interventions: a review of current literature and ongoing studies. International Aids Society-USA, Topics in HIV Medicine. 2003;11(6):185-198. Available from: Available from: https://www.iasusa.org/wp-content/uploads/2003/11/11-6-185.pdf >. Access on 17 nov 2018.
» https://www.iasusa.org/wp-content/uploads/2003/11/11-6-185.pdf
Tafur Valderrama EJ, Ortiz Alfaro C, García-Giménez E, Faus Dader MJ, Martínez Martínez F. Impacto de la intervención farmacéutica en la adherencia al tratamiento antirretroviral en pacientes de un hospital de Lima (Perú). Pharm Care España. 2012;14(4): 146.
Tello-Velásquez JR, Díaz-Lianes BE, Mezones-Holguín E, Rodrígues-Morales AJ, Huamaní C, Hernández AV, et al. La mala calidad de sueño se asocia a una menor adherencia al tratamiento antirretroviral de gran actividad en pacientes peruanos con infección por VIH/SIDA. Cad Saúde Pública Rio de Janeiro . 2015;31(5):989-1002.
Unaids. Report on Viral suppression is an important tool in HIV. Switzerland: Unaids; 2016. Available from: Available from: https://unaids.org.br/2016/12/testando-supressao-viral/ Access on 15 nov 2018.
» https://unaids.org.br/2016/12/testando-supressao-viral/
Vieira ACS, Rocha MSG, Head JF, Casimiro IMAPC. A epidemia de HIV/Aids e a ação do Estado. Diferenças entre Brasil, África do Sul e Moçambique. Rev Katál. 2014;17(2):196-206.
Weldring T, Smith SM. Patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs). Health Serv Insights. 2013;6:61-68.
Zuge SS, Primeira MR, Remor E, Magnago TSBS, Paula CC, Padoin SMM. Fatores associados a adesão ao tratamento antirretroviral em adultos infectados pelo HIV: estudo transversal. Rev Enferm UFSM. 2017;7(4):577-589.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Brazilian Journal of Pharmaceutical Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content of the journal, except where identified, is licensed under a Creative Commons attribution-type BY.
The on line journal has open and free access.
