Pharmacist-led counselling intervention to improve antiretroviral drug adherence in Pakistan: a randomized controlled trial

BMC Infect Dis. 2020 Nov 23;20(1):874. doi: 10.1186/s12879-020-05571-w.

Abstract

Background: Pakistan is facing a growing population of people living with human immunodeficiency (HIV). In this randomized controlled trial, we investigate if a pharmacist-led intervention can increase adherence to antiretroviral therapy (ART) for people living with HIV (PLWH).

Methods: Adults with HIV, who have been taking ART for more than 3 months were randomly assigned to receive either a pharmacist-led intervention or their usual care. Measures of adherence were collected at 1) baseline 2) just prior to delivery of intervention and 3) 8 weeks later. The primary outcomes were CD4 cell count and self-reported adherence measured with the AIDS Clinical Trial Group (ACTG) questionnaire.

Results: Post-intervention, the intervention group showed a statistically significant increase in CD4 cell counts as compared to the usual care group (p = 0.0054). In addition, adherence improved in the intervention group, with participants being 5.96 times more likely to report having not missed their medication for longer periods of time (p = 0.0086) while participants in the intervention group were 7.74 times more likely to report missing their ART less frequently (p < 0.0001).

Conclusions: The findings support the improvement in ART adherence and HIV management.

Trial registration: The trial is registered with Australian New Zealand Clinical Trials Registry ( ACTRN12618001882213 ). Registered 20 November 2018.

Keywords: ART adherence; Counselling; HIV; Pharmacist intervention; Prevention.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use*
  • CD4 Lymphocyte Count
  • Counseling / methods*
  • Female
  • HIV / immunology*
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / virology
  • Humans
  • Male
  • Medication Adherence / psychology*
  • Middle Aged
  • Pakistan / epidemiology
  • Pharmacists / psychology*
  • Risk Factors
  • Self Report
  • Single-Blind Method
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Retroviral Agents