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- Title
Retention in HIV Care Among Participants in the Patient-Centered HIV Care Model: A Collaboration Between Community-Based Pharmacists and Primary Medical Providers.
- Authors
Byrd, Kathy K.; Hardnett, Felicia; Clay, Patrick G.; Delpino, Ambrose; Hazen, Ron; Shankle, Michael D.; Camp, Nasima M.; Suzuki, Sumihiro; Weidle, Paul J.; Aguirre, Michael; Akinbosoye, Osayi; Bamberger, David M.; Bluml, Ben; Bullock, Katura; Burrell, Diane C.; Bush, Tim; Bush, Clifton; Cadwell, Chad; Cardarelli, Roberto; Clark, Terri
- Abstract
Poor retention in HIV care is associated with higher morbidity and mortality and greater risk of HIV transmission. The Patient-Centered HIV Care Model (PCHCM) integrated community-based pharmacists with medical providers. The model required sharing of patient clinical information and collaborative therapy-related action planning. The proportion of persons retained in care (≥1 medical visit in each 6-month period of a 12-month measurement period with ≥60 days between visits), pre- and post-PCHCM implementation, was modeled using log binomial regression. Factors associated with post-implementation retention were determined using multi-variable regression. Of 765 enrolled persons, the plurality were male (n = 555) and non-Hispanic black (n = 331), with a median age of 48 years (interquartile range = 38–55); 680 and 625 persons were included in the pre- and post-implementation analyses, respectively. Overall, retention improved 12.9% (60.7–68.5%, p = 0.002). The largest improvement was seen among non-Hispanic black persons, 22.6% increase (59.7–73.2%, p < 0.001). Persons who were non-Hispanic black [adjusted risk ratio (ARR) 1.27, 95% confidence interval (CI) 1.08–1.48] received one or more pharmacist–clinic developed action plan (ARR 1.51, 95% CI 1.18–1.93), had three or more pharmacist encounters (ARR 1.17, 95% CI 1.05–1.30), were more likely to be retained post-implementation. In the final multi-variable models, only race/ethnicity [non-Hispanic black (ARR 1.27, 95% CI 1.09–1.48) and "other or unknown" race/ethnicity (ARR 1.36, 95% CI 1.14–1.63)] showed an association with post-implementation retention. PCHCM demonstrated how collaborations between community-based pharmacists and primary medical providers can improve retention in HIV care. This care model may be particularly useful for non-Hispanic black persons who often are less likely to be retained in care.
- Subjects
CONFIDENCE intervals; CONTINUUM of care; HIV-positive persons; INTERPROFESSIONAL relations; MEDICAL personnel; PATIENT compliance; PHARMACISTS; RACE; REGRESSION analysis; PRE-tests &; post-tests; PATIENT-centered care
- Publication
AIDS Patient Care & STDs, 2019, Vol 33, Issue 2, p58
- ISSN
1087-2914
- Publication type
Article
- DOI
10.1089/apc.2018.0216