HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by March, K. Articles by Louie, S. G. Search for Related Content PubMed PubMed Citation Articles by March, K. Articles by Louie, S. G.

KRISTI MARCH, PHARM.D., BCPS, is Clinical Pharmacist, Primary Care, San Francisco General Hospital, San Francisco, CA. MAY MAK, PHARM.D., CDE, is Assistant Professor; and STAN G. LOUIE, PHARM.D., is Associate Professor, School of Pharmacy, University of. Southern California, Los Angeles.

Address correspondence to Dr. Mak at the School of Pharmacy, University of Southern California, 1985 Zonal Avenue, Los Angeles, CA 90033 (mmak{at}usc.edu).

Purpose. The effects of pharmacists’ interventions on patient outcomes in an HIV primary care clinic were studied. Methods. All study participants were referred to a pharmacist-managed drug optimization clinic (DOC) in a county-based HIV primary care clinic between November 1, 2003, and September 30, 2004. Patients were eligible for study participation if they were 18 years of age or older and gave informed consent to participate. Pharmacists’ interventions were categorized as follows: patient education, addition of a medication, dosage adjustment, discontinuation of a medication, and interpretation of viral-resistance tests. Changes in baseline CD4+ T-lymphocyte counts and viral load were also measured over the study period. Toxicities related to highly active antiretroviral therapy were recorded and graded from 0 to 4, with 0 indicating no toxicity and 4 indicating severe toxicity. Study participants used a standardized survey to measure their own health-related quality of life. Changes in CD4+ lymphocyte counts and viral load were analyzed using Student’s t test and analysis of variance. Toxicity grades were analyzed using the Wilcoxon signed-rank test. Results. A total of 34 patients completed the study. Pharmacists made a total of 253 interventions, most of which were categorized as patient education. The mean CD4+ lymphocyte count increased from baseline levels by 54 ± 78 cells/mm3 over the study period (p < 0.0002). The mean ± S.D. reduction in circulating viral load over the study period was 1.02 log10 copies/mL ( p < 0.004). Conclusion. HIV-infected patients who were managed by pharmacists in a DOC demonstrated significant improvement from baseline in their CD4+ lymphocyte counts, viral loads, and drug-related toxicities. Index terms: Ambulatory care; Antiretroviral agents; Dosage; HIV infections; Interventions; Patient information; Pharmaceutical services; Pharmacists; Quality of life; Toxicity