Effect of Pharmacist Care on Clinical Outcomes Among People Living with HIV/AIDS: A Systematic Review and Meta-Analysis
Author(s)
Ahmed A1, Dujaili J2, Awaisu A3, Chaiyakunapruk N4
1Monash University Malaysia, Jalan Lagoon Selatan, 10, Malaysia, 2Monash University Malaysia, Bandar Sunway, Malaysia, 3Qatar University, Doha, Qatar, 4University of Utah, Salt Lake City, UT, USA
Presentation Documents
OBJECTIVES Pharmacists play a significant role in the multidisciplinary care of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA). However, there is less evidence to clarify the impact of pharmacist as an individual team member on HIV care. Therefore, this study aims to determine the effects of pharmacist intervention on improving adherence to antiretroviral therapy (ART), viral load (VL) suppression, and change in CD4-T lymphocytes in PLWHA. METHODS We identified relevant records from six databases (Pubmed, EMBASE, ProQuest, Scopus, Cochrane, and EBSCOhost) from inception till June 2020. We included studies that evaluated the impact of pharmacist care activities on clinical outcomes in PLWHA. A random-effect model was used to estimate the overall effect [odds ratio (OR) for dichotomous and mean difference (MD) for continuous data] with 95% confidence intervals (CIs). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to evaluate the quality of evidence. The review protocol was published on PROSPERO (CRD42020167994). RESULTS Twenty-five studies involving 3,206 PLWHA in which pharmacist-provided intervention either in the form of education with or without pharmaceutical-care either alone or as an interdisciplinary team member were included. Eight studies were randomized controlled trials (RCTs), while 17 studies were non-RCTs. Pooled-analyses showed a significant impact of pharmacist care compared to usual care group on adherence outcome (OR: 2.70 [95%, CI 1.80, 4.05]), VL suppression (OR: 4.13 [95% CI 2.27, 7.50]), and rise of CD4-T lymphocytes count (MD: 66.83 cells/mm3 [95% CI 44.08, 89.57]). The strength of evidence ranged from moderate, low to very low. CONCLUSIONS The findings suggest that pharmacist care has a positive impact on improving adherence, VL suppression, and improvement of CD4-T lymphocytes in PLWHA. Further studies with more rigorous designs are needed to reaffirm the impact of pharmacist interventions on clinical and economic outcomes among PLWHA.
Conference/Value in Health Info
2021-11, ISPOR Europe 2021, Copenhagen, Denmark
Value in Health, Volume 24, Issue 12, S2 (December 2021)
Code
POSA253
Topic
Clinical Outcomes, Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Clinical Outcomes Assessment, Comparative Effectiveness or Efficacy, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Infectious Disease (non-vaccine)