In Developing World, Pharmacies Can Play Important Role for HIV Patients

Adult patients living with HIV that were virologically suppressed remained virologically stable with optimal adherence and retention in care when willingly chose to refill prescriptions in Community Pharmacies (Co-Pharm) after transistioning away from hospital settings, according to a new study.

An overwhelming majority (98%) of the participants were retained in care, and 85% had optimal adherence.

“Patients remained virologically stable with optimal adherence and retention in care,” the investigators wrote.

These findings were presented at the International AIDS Society (IAS) AIDS 2020 Virtual Sessions.

In developing countries with overcrowded hospitals, community pharmacies can relive burden, help patients adhere to their regimen, thus offering a viable alternative to patients who need to maintain their medication and keep stable.

This study was done in Southern Nigeria from January 2017 to June 2019. The study included 2,938 patients who had a viral load of less than 20 copies/mL, and were recruited and enrolled in a community based program where patients refilled prescriptions in a registered Co-Pharm. Baseline log viral load(VL) was 3.7; no significant difference in median VL before and after participants devolved to the Co-Pharm. The before median VL = 2.9 log copies/mL versus after the median VL = 2.9 log copies/mL.

Twenty nine public hospitals and 64 registered community pharmacies were recruited. This was a non-randomized intervention study.

Sociodemographic and treatment data (medication regimen, prescription refill, retention in care and viral load) were collected. Baseline virologic suppression before patients devolved to the Co-Pharm was compared with the patients' virologic suppression data after 12 months of devolvement.

The World Health Organization has recommended using community-based models for scaling up HIV treatment.

“This [study] suggests that patients who are already virologically suppressed may remain stable even if they are devolved from the hospitals to the Co-Pharm,” the investigators concluded.