Impact of pharmaceutical care interventions on the resolution of drug therapy problems among HIV-infected patients on second-line antiretroviral therapy in a Nigerian tertiary healthcare facility Impact des interventions de soins pharmaceutiques sur la résolution des problèmes liés au traitement médicamenteux chez les patients infectés par le VIH sous traitement antirétroviral de deuxième ligne dans un établissement de soins tertiaires nigérian
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Abstract
Background: Drug Therapy Problems (DTPs) are a major obstacle to effective disease management and treatment success, especially in chronic conditions like HIV infection.
Objectives: This study evaluated the impact of pharmaceutical care interventions on the resolution of DTPs and medication adherence among HIV-infected patients on second-line antiretroviral therapy (ART) at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
Methods: This was a prospective interventional study involving 107 HIV patients on second-line ART. The patients were assessed for DTPs during routine clinic visits, and interventions such as medication counselling, ADR management, and adherence support were provided and followed for 8 weeks. The identified DTPs were categorized using the Pharmaceutical Care Network Europe (PCNE) Classification System. Data were analyzed using descriptive statistics and the student t-test, with significance set at p< 0.05.
Results: Eighty-two DTPs were identified among 71 patients (66.4 %), with an average of 1.2 DTPs per patient. Nonadherence (81.7 %) and ADRs (18.3 %) were the most common DTPs identified, mainly due to inappropriate drug combinations and patient not taking their drugs. All the interventions were accepted by the patients and the prescribers, resulting in a 100 % acceptance rate. During follow-up, 95.1 % of the identified DTPs were resolved, and medication adherence significantly improved by 0.682± 0.708 (t = 9.962, p< 0.001).
Conclusion: Pharmaceutical care interventions significantly reduced DTPs and improved adherence. Incorporating such care into HIV treatment is recommended to enhance patient outcomes.
Résumé
Contexte: Les problèmes liés à la pharmacothérapie (PLP) constituent un obstacle majeur à la prise en charge efficace des maladies et au succès du traitement, notamment dans les affections chroniques comme l'infection par le VIH.
Objectifs: Cette étude a évalué l'impact des interventions de soins pharmaceutiques sur la résolution des problèmes liés à la pharmacothérapie et l'observance thérapeutique chez les patients infectés par le VIH sous traitement antirétroviral de deuxième ligne au centre hospitalier universitaire Usmanu Danfodiyo, Sokoto, Nigéria.
Méthodes: Il s'agissait d'une étude interventionnelle prospective menée auprès de 107 patients séropositifs sous traitement antirétroviral de deuxième ligne. Les patients ont été évalués pour les problèmes liés à la pharmacothérapie (PLP) lors de leurs consultations de routine. Des interventions telles que des conseils sur les médicaments, la prise en charge des effets indésirables et un soutien à l'observance ont été mises en place et suivies pendant 8 semaines. Les PLP identifiés ont été classés selon la classification du Pharmaceutical Care Network Europe (PCNE). Les données ont été analysées à l'aide de statistiques descriptives et du test t de Student, avec un seuil de signification fixé à p < 0.05.
Résultats: Quatre-vingt-deux problèmes liés à la pharmacothérapie (PLP) ont été identifiés chez 71 patients (66.4 %), soit en moyenne 1.2 PLP par patient. La non-observance (81.7 %) et les effets indésirables (18.3 %) étaient les PLP les plus fréquents, principalement dus à des associations médicamenteuses inappropriées et à l'arrêt du traitement. Toutes les interventions ont été acceptées par les patients et les prescripteurs, soit un taux d'acceptation de 100 %. Lors du suivi, 95.1 % des PLP identifiés ont été résolus et l'observance thérapeutique s'est améliorée de manière significative (0.682 ± 0.708 ; t = 9.962 ; p < 0.001).
Conclusion: Les interventions pharmaceutiques ont réduit de manière significative les problèmes liés à la pharmacothérapie et ont amélioré l'observance. Il est recommandé d'intégrer ces interventions au traitement du VIH afin d'améliorer les résultats pour les patients.
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