Pharmacists’ Intervention to Reduce Drug Related Problems in HIV/AIDS Patients on Haart in a Tertiary Health Facility in Southern Nigeria

Abstract

Despite advances in the use of highly active antiretroviral therapy (HAART) in the management of HIV/AIDS, drug-related problems (DRPs) still remain an issue, particularly in developing countries. This study evaluated the incidence of DRPs among HIV/AIDS patients in a HIV/AIDS care centre in southern Nigeria and the impact of pharmacist’s intervention in reducing the problems. Two hundred and ninety-seven (297) HIV/AIDS out-patients (age, 41±11.3 yrs) on HAART previously for at least 2 years that were refilling their HAART drugs at Infectious Diseases Clinic in University of Benin Teaching Hospital (UBTH), Benin City based on pharmacy order form (POF), were recruited for the study. Patients’ DRPs data were collected on recruitment (baseline) and the 269 patients with DRPs were followed by the pharmacist at 3, 6 and 9 months with education/counselling of patients and their prescribers were contacted as appropriate. At baseline, 652 DRPs were recorded in 90.6% of the 297 patients recruited out of which 29.4% are directly related to the use of the POF. DRPs observed were generic drug substitution (28.7%), inappropriate drug adherence (17.5%), dosing interval not indicated (12.7%), dose not indicated (10.6%), inadequate patient’s knowledge of appropriate drug use (9.4%), drug-drug interactions (7.8%), side effects (7.2%), dosage too low (3.2%), dosage too high (2.0%) and wrongly prescribed drug (0.9%). In the 9th month following pharmacist’s intervention 61.2% of the identified DRPs were partially solved and 38.8% were completely resolved among the 194 patients not lost to follow-up. Also, all DRPs related to the use of POF were completely resolved. Active participation of clinical pharmacists in the care of HIV/AIDS patients is vital in the prevention and reduction of DRPs in HIV/AIDS patients undergoing ambulatory care.

Keywords: Drug related problems, HIV/AIDS, generic substitution, overdose, under dose, drug