Pharmacy care perspectives on problems with HIV antiretroviral therapy in Sweden
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This study has three main objectives (1) to identify the major problems or difficulties pharmacy staff in Sweden experience regarding pharmacy care of patients receiving antiretroviral therapy, (2) to identify the perceptions of pharmacy staff regarding what are patient-related concerns with antiretroviral therapy and (3) to compare the extent to which pharmacy staff awareness matches patient perceptions regarding what are the major problems or difficulties associated with antiretroviral therapy.
A problem detection study (PDS) containing two questionnaires was conducted: one to be completed by pharmacy staff and another to be completed by both pharmacy staff and patients. In the latter survey, staff were asked about what they thought that patients would have responded. Staff and patient responses were then matched and compared with one another.
The pharmacy staff expressed their need for continuous education so as to assist the patients with their complex regimens. The staff were aware that patients were worried about therapy failure and viral resistance, medication-related problems and negative attitudes from the public. The staff however were less aware of the extent to which patients worried about not having their HIV infection under control. The staff also valued written patient information to a much higher extent than the patients.
The pharmacy staff’ awareness of the major problems HIV patients are experiencing seems incomplete and may lead to lack of concordance between the patients and pharmacy staff. This in turn may lead to non-adherence and poor therapy outcomes. Pharmacy staff should be encouraged to improve and systematically assess patient issues regarding antiretroviral therapy. Through assessing patient needs and concerns, the pharmacists can better identify patient needs and thus better tailor their educational and behavioural interventions to improve therapy outcomes.
KeywordsAdherence AIDS Antiretroviral therapy Concordance Drug-related problems Drug-use problems HIV Patient counselling Pharmacy care Pharmacy staff Sweden
Funding This work was funded by the National Corporation of Swedish Pharmacies (Apoteket AB) and the Swedish Foundation for Strategic Research. The authors thank Sveriges Farmaceutiska Sällskap for awarding a scholarship to the project and pharmacist Lena Lagerholm for assistance. Special thanks to the staff of RFHP (the Swedish Group for HIV Positives), Convictus (former injecting drug users) and OASEN (group for origins of Sub-Saharan Africa) for their invaluable support in collecting the study data. We are most grateful to the staff at the Stockholm pharmacies (Huddinge University Hospital, Ugglan, South Hospital, C W Scheele, Enhörningen, Karolinska, and Danderyd) and Clinics (Huddinge University Hospital, Danderyd Hospital, South Hospital, and Karolinska Hospital). Thanks to the Pharmacist Mr and Mrs Mgbemena for reading the final stage of the manuscript.
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