Pharmaceutical interventions in antiretroviral therapy: systematic review and meta-analysis of randomized clinical trials

J Clin Pharm Ther. 2015 Jun;40(3):251-8. doi: 10.1111/jcpt.12253. Epub 2015 Mar 24.

Abstract

What is known and objective: High levels of adherence to antiretroviral therapy (ART) are needed to achieve the desired results. Because pharmaceutical care might contribute to improved adherence to treatment, the aim of this study was to assess the impact of pharmaceutical interventions on ART via a systematic review of randomized clinical trials (RCT).

Methods: Study selection, data extraction and risk-of-bias assessment were performed independently by two reviewers.

Results and discussion: A total of 681 studies were located; only four of these met the inclusion criteria and were analysed. The summary measure corresponding to the outcome adherence to treatment was 1·47 (95% confidence interval [CI]: 0·81-2·65), and the measure corresponding to the outcome virologic suppression was 1·95 (95% CI: 0·61-6·25).

What is new and conclusion: The results suggest that pharmaceutical interventions might contribute to improved adherence to ART and the achievement of virologic suppression, although the differences between the intervention and control groups were not statistically significant. Pharmaceutical interventions might be more efficacious in populations with low adherence to treatment and greater vulnerability.

Keywords: acquired immunodeficiency syndrome; adherence; antiretroviral therapy; human immunodeficiency virus; meta-analysis; pharmaceutical care; systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / therapeutic use*
  • HIV Infections / drug therapy*
  • Humans
  • Medication Adherence*
  • Pharmaceutical Services / organization & administration
  • Randomized Controlled Trials as Topic

Substances

  • Anti-HIV Agents