ASSESSMENT OF THE ROLE OF THE PHARMACIST IN ADHERENCE TO ANTIRETROVIRAL THERAPYIN PATIENTS OF CARIBBEAN DESCENT IN SOUTH FLORIDA

POSTER PRESENTATIONS

Objective. The primary objective of this study is to assess the role of the pharmacist in HIV medication adherence. The secondary objective will be to determine factors that affect medication adherence to antiretroviral therapy in patients of Caribbean descent. Background. At the end of 2012, 1.2 million people in the United States were living with HIV. 1 In 2010, African Americans and Hispanic/Latinos made up 44% and 21% of new HIV infections respectively. People of Caribbean descent are a growing minority racial/ethnic group in the United States and are often misclassified with other minority groups. The Caribbean population is also grossly understudied and efforts need to be made to characterize HIV/AIDS in this population. There have been many breakthroughs in anti-retroviral therapy (ART), which not only have improved clinical and health outcomes, but also the patient’s quality of life. Strict adherence to ART is needed for the most benefit.3,4 Pharmacists can help HIV-infected patients deal with barriers to medication access, and adhering to medication regimens. Medication adherence is critical to the efficacy of ART and pharmacists can have a significant impact in this area of HIV patient care. Methods. This is a cross-sectional observational community-based study currently being conducted using face-to-face interviews at a clinic in Hollywood, Florida. A convenient sample of adult patients diagnosed with HIV/AIDS, currently on anti-retroviral therapy, and either a Caribbean island native or the first generation born of a Caribbean island native will be included in this study. A total of 100 patients will be interviewed. Patients will be interviewed using open-ended, multiplechoice and Likert scale questions to determine factors that affect medication adherence. During the interview, patients will be asked the following: Everyone at this clinic is concerned with your health and your adherence to your medications. List the top 3 that in your opinion helped you the most with adherence to your HIV drugs. Participants were allowed to name the 44 providers spontaneously. However, the answer options for the patient include: social worker/case worker, counselor, pharmacist, lab technician, medical assistant, nutritionist, nurses, nurse practitioner, doctors or others. Medication adherence is the dependent variable in this study and measured by a 3 day self-report recall. Regression analyses will be performed to determine the impact of the pharmacist's role on adherence. Descriptive analyses (means, medians, ranges) will also be used to discuss the findings. Results. (Preliminary) 14.6% of patients listed the pharmacist as a health care professional that was concerned about their health and medication adherence 96.1% of patients missed a medication dose within the last 3 days before the interview Mean of the most recent CD4 count (absolute) of patients: 587.6 62.1% of patients had a most recent record of an undetectable viral load 82.5% of patients were born in the Caribbean; 17.5% of patients were born in the United States For the parents of the patients born in the United States: 29.4% were born in Jamaica, 17.6% were born in Puerto Rico and 53% were born in other Caribbean countries Conclusion. Nonadherence to antiretroviral treatment is relatively high in this population. There is a need for pharmacist intervention to improve adherence and to ultimately improve therapeutic outcomes. This population faces significantly more barriers to healthcare than other minority groups. These include economic and cultural barriers which can greatly impact access to medication, as well as their personal and public beliefs of their treatment and care. Grants. NIH/NIMH 5R25MH083617