Impact of HIV-specialized pharmacies on adherence to medications for comorbid conditions

J Am Pharm Assoc (2003). Sep-Oct 2014;54(5):493-501. doi: 10.1331/JAPhA.2014.13165.

Abstract

Objective: To determine if patients using human immunodeficiency virus (HIV)-specialized pharmacies have greater adherence to drugs used to treat comorbid conditions and HIV compared with patients who use traditional pharmacies.

Design: Retrospective cohort study, with patients' propensity matched based on pharmacy use: HIV-specialized versus traditional.

Setting: Nationwide pharmacy chain.

Participants: Adult patients who filled at least two prescriptions for an antiretroviral therapy (ART). Patients also needed to have at least two prescriptions for an angiotensin-converting enzyme (ACE) inhibitor/angiotensin receptor blocker (ARB) or a statin for analyses examining comorbid conditions.

Main outcome measure: Proportion of days covered (PDC).

Results: The adherence analyses for ART, ACE inhibitors/ARBs, and statins included 14,278, 1,484, and 1,372 pairs, respectively. The mean PDC for ART patients using HIV-specialized pharmacies was higher than that for patients using traditional pharmacies (86.20% vs. 81.87%; P <0.0001). Patients taking ACE inhibitors/ARBs in the specialized group also had a higher mean PDC compared with patients in the traditional group (82.61 vs. 79.66; P = 0.0002), as did specialized pharmacy users in the statin group (83.77 vs. 81.29; P = 0.0009).

Conclusion: HIV patients managed by an HIV-specialized pharmacy have significantly higher adherence to medication for comorbid conditions compared with patients using traditional pharmacies. Patients of HIV-specialized pharmacies also have significantly higher adherence to ART compared with peers using traditional pharmacies.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Angiotensin Receptor Antagonists / administration & dosage
  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / administration & dosage
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / therapeutic use
  • Cohort Studies
  • Community Pharmacy Services / organization & administration*
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Medication Adherence*
  • Middle Aged
  • Retrospective Studies
  • Specialization

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Anti-HIV Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors