(1306) Comparison of Adherence to Antiretroviral Medications Among Adult Patients with HIV Between Clinical Managed and Refill Reminder-only Services in a Specialty Pharmacy Setting

Objectives: The primary objective is to compare the difference in the number of adult patients with HIV meeting the 90% Proportion of Days Covered (PDC) threshold between those clinically managed and those receiving Refill Reminder-Only (RRO) service in a specialty pharmacy setting over a 12-month period.

The secondary objective is to compare the difference in 12-month antiretroviral (ARV) PDC between clinically managed and RRO services among adult patients with HIV in a specialty pharmacy setting.



Effective HIV treatment requires multiple ARV medications to meet therapy goals, but this complexity can lead to adherence challenges. Achieving 90% adherence to ARV therapy is crucial for viral suppression and treatment success. Poor adherence increases the risk of treatment failure and resistance. Pharmacist-led clinical management includes various responsibilities, like lab monitoring, adherence assessment, counseling, and addressing concerns. While pharmacist-led programs have improved adherence in chronic conditions, limited research specifically addresses HIV patients. HIV patients using specialized pharmacies have been found to have higher medication adherence rates than those without such services. There is a need to further assess how specialty pharmacy clinical management impacts adherence, outcomes, and cost-effectiveness within this specific population.

Methods: This comparative, retrospective study will use a joint clinical program and pharmacy database of HIV patients who received antiretroviral medications at a single-center specialty pharmacy over a 12-month period. Patients in the intervention group were clinically managed, meaning they were enrolled in all calls the site offered, including pharmacist assessment calls. Those in the control group received RRO service. Included patients are those who were 18 years of age or older, on a stable ARV regimen for 90 days prior to the start of the study period, taking oral-only ARV regimen with 3 or more ARV components, and filled exclusively at the study site. Patients will be excluded if they switched from clinically managed to RRO service or switched from RRO service to clinically managed during the study period and patients who were unenrolled for all calls at any point during the study period. The pharmacy dispensing software and clinical program will be used for patient identification and data collection. Collected data will include patient age, components of ARV regimen, PDC for the study duration, and call type. PDC will be determined by dividing the quantity of days with ARV coverage throughout the study period by the duration of the study period. The primary endpoint will be analyzed using a chi-square test, and the secondary endpoint will be analyzed using a t-test.

Results: N/A

Conclusions: N/A