Implementation of a patient-centered HIV care model to optimize outcomes

Abstract

By integrating care and improving communication between pharmacists and HIV clinical providers, the Patient-Centered HIV Care Model (PCHCM) project aims to improve HIV clinical outcomes by increasing retention in care, adherence to ART, and viral suppression.

Proposal Summary

Introduction: Antiretroviral therapy (ART) reduces mortality among HIV-infected individuals who remain engaged in care and adherent to therapy; yet, only 30% of those diagnosed with HIV are virologically suppressed. By integrating care and improving communication between pharmacists and other HIV clinical providers, the Patient-Centered HIV Care Model (PCHCM) project aims to increase retention in care and adherence to ART, thereby improving HIV clinical outcomes. Description: The PCHCM project, which began in September 2013, will enroll 1000 HIV-infected clients, emphasizing minority enrollment. Clinical providers share complete medical history with partnered pharmacists in preparation for Medication Therapy Management (MTM) services; monitoring of communication and collaboration between the provider, pharmacist, and patient continue throughout the project period. As part of implementation, the project team has identified partner clinic-pharmacy sites, developed and delivered site training, and is providing ongoing project oversight, data management and analysis. This includes individual and all site meetings to discuss early challenges and successes to project implementation. Data collection includes clinical outcomes gathered from medical and pharmacy record abstraction. Lessons Learned: As of January 2015, seven sites are participating and have initiated recruitment. Overall, 114 patients were scheduled for the initial MTM visit, of which 63 (55%) have been completed and 51 are pending. Current reported challenges include recruitment (clients unable or unwilling to switch pharmacies) and enrollment (delay in scheduling MTM visit, missed MTM visits) barriers. Early successes cited by project sites include corrected timing of medication administration, improved understanding of complex medication regimens, and more meaningful communication between pharmacists and providers, and more organized HIV-specific communication between pharmacists and clients. Recommendations: To construct best practices, the project team will continue to assess challenges and successes with the PCHCM. Data analysis will be conducted to evaluate pharmacist-provider communication patterns and the impact of the PCHCM on HIV clinical outcomes. Previously presented at the 10th International Conference on HIV Treatment and Prevention Adherence; Miami, FL. June 28-30, 2015.

Relevance And Significance

This proposal relates best to the following conference tracks: o Innovative strategies and tools for prevention and intervention in rural communities o Medical access and compliance issues among rural populations This proposal describes implementation of an innovative strategy (i.e. a patient-centered HIV care model that focuses on collaborative communication between pharmacists and other HIV clinical providers) to improve clinical outcomes among HIV-infected patients. This strategy is particularly relevant for and adaptable to rural communities given its inclusion of the pharmacist, an easily accessible healthcare provider even in rural settings, as part of the multidisciplinary HIV care team. Through implementation of this HIV care model, the project aims to improve retention in HIV care and improve rates of antiretroviral adherence, both foci of the second track, noted above. The geographical scope of this project is diverse and includes rural, urban and suburban settings. Best practices for the rural setting, in particular, can be shared as part of the presentation at this conference. The Rural HIV Model Clinic, which is part of the Albany Area Primary Health Care, Inc., is notably the project's largest partner within a rural setting.

Session Format

Presentation Session

Keywords

patient-centered HIV care, pharmacist, medication therapy management, communication

Publication Type and Release Option

Presentation (Open Access)

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Implementation of a patient-centered HIV care model to optimize outcomes

By integrating care and improving communication between pharmacists and HIV clinical providers, the Patient-Centered HIV Care Model (PCHCM) project aims to improve HIV clinical outcomes by increasing retention in care, adherence to ART, and viral suppression.