Patient-Centered HIV Care Model Improves Viral Suppression

Integrated care models between community-based pharmacists and primary medical providers may identify and address HIV therapy–related challenges and improve viral suppression (VS) among individuals with HIV, according to a new study.

This determination comes after the Patient-Centered HIV Care Model was shown to improve VS among the study participants by a relative 15%.

To assess its efficacy, the model was implemented at 10 sites from August 2014 to September 2016. The model integrated community-based pharmacists with HIV medical providers and required them to share patient clinical information, identify therapy-related problems, and develop therapy-related action plans.

Among the 765 participants, 43% were non-Hispanic black and 73% were men; the median age was 48 years. 

The proportion of patients who adhered to antiretroviral therapy (proportion of days covered [PDC] ≥90%) before and after model implementation was assessed among 421 participants. The proportion of patients virally suppressed (HIV RNA <200 copies/mL) before and after model implementation was assessed among 649 participants.

While proportions of participants who adhered to therapy remained unchanged, VS increased by a relative 15%, from 75% preimplementation to 86% postimplementation. According to the study authors, this improvement was likely due to pharmacists’ and medical providers’ efforts to optimize antiretroviral treatment.

Higher PDC and baseline VS were associated with postimplementation VS. And although non-Hispanic blacks had lower odds of suppression, VS increased a relative 23%, from 63% to 78%, among this population.

—Colleen Murphy

Reference:

Byrd KK, Hou JG, Bush T; Patient-Centered HIV Care Model Team. Adherence and viral suppression among participants of the Patient-Centered Human Immunodeficiency Virus (HIV) Care Model project: a collaboration between community-based pharmacists and HIV clinical providers. Clin Infect Dis. 2020;70(5):789-797. https://doi.org/10.1093/cid/ciz276.