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DESIGN AND IMPLEMENTATION OF A PROGRAM FOR THE ADMINISTRATION AND FOLLOW-UP OF PHARMACOTHERAPEUTIC DRUGS IN PATIENTS WITH LONG-ACTING ANTI-HIV DRUGS

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European Statement

Clinical Pharmacy Services

Author(s)

MARTÍNEZ LLIBERATO, A; COMPANY ALBIR, MJ; VICENTE ESCRIG, E; VALLEJO GARCÍA, R; RUBIO ORTOLÁ, L; GARCÍA MONTAÑÉS, S; BELLÉS MEDALL, MD; FERRANDO PIQUERES, R

Why was it done?

It was carried out to ensure the best monitoring, traceability and conservation of long-acting antiretroviral drugs, as well as to improve adherence and patient quality of life and reduce stigma in HIV patients.

What was done?

A program was developed for the administration and pharmacotherapeutic monitoring of patients who are candidates for long-acting antiretroviral treatment (LA-ART), coordinated with the infectious diseases unit (IDU) and the Hospital Pharmacy Outpatient Unit (HPOU).

How was it done?

After the inclusion of the drugs in the pharmacotherapeutic guide, the following program was designed:
1. Identification and communication to the HPOU by the IDU of patients who are candidates for LA-ART and electronic prescription.
2. Initial visit (week 0):
• Review and validation of the treatment by the pharmacist: indication, dosage regimen, interactions, contraindications.
• Planning of the annual administration calendar, providing two dates within the window period allowed by these drugs. Patients are scheduled for pharmaceutical care (PC) and administration on working Thursdays, in the HPOU Health Education Consultation agenda, which has a nurse.
• Information to the patient by the pharmacist, orally and in writing, about administration and adverse reactions. In addition, the annual appointment schedule is provided.
• Appointment of the patient for the first successive visit, if the patient accepts the start.
3. SMS sent the day before, to remind the patient of the follow-up visit. If the patient cannot attend the scheduled appointment, he/she will contact the HPOU to schedule an alternative date according to the calendar.
4. Successive visits (week 4 and every 8 weeks):
• PC
• Intramuscular administration by a nurse.
In all visits, the information is recorded in the patient’s computerized medical history.

What has been achieved?

Of 18 candidate patients in 18 months, 15 accepted ART after the initial visit. 89 PC and administration consultations have been carried out. Adherence was 100%, all reported local discomfort at the injection site between 1 and 7 days after administration and only 1 patient reported pyrexia.

What next?

A program applicable to all HPOU that have nursing and a Health Education consultation to implement adherence in these patients.

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