Use of an On-Site Outpatient Pharmacy for Acquisition of Antiretroviral Medications Compared to Off-Site Pharmacy Options: Impact on Retention in Care and Clinical Outcomes in People Living With HIV

J Pharm Pract. 2021 Apr;34(2):224-229. doi: 10.1177/0897190019866324. Epub 2019 Aug 1.

Abstract

Background: Few published studies have examined the relationship between pharmacy location and retention in care or clinical outcome in people living with HIV (PLWH).

Objective: The study purpose was to determine whether using an on-site/in-clinic pharmacy to obtain antiretroviral therapy increased retention in care and virologic suppression rates.

Methods: PLWH attending a Ryan White outpatient clinic in an academic center were matched based on age and insurance. Rates of retention in care ( ≥2 medical visits/calendar year) were assessed between patients using a pharmacy on-site in the clinic versus patients use off-site pharmacy options. Virologic suppression [viral load(VL)<200 copies/mL], completing ≥2 VL, and CD4 count were compared between pharmacy types.

Results: 137 on-site pharmacy patients and 274 off-site pharmacy patients met inclusion and matching criteria. 91.2% of on-site pharmacy users attended ≥2 clinic visits compared to 83.2% of off-site pharmacy users (P = .0275) and were approximately twice as likely to complete ≥2 clinic visits (odds ratio: 2.032; 1.071-3.857). A similar proportion of the on-site pharmacy group achieved virologic suppression compared to the off-site pharmacy group (92.7% vs 89.1%; P = .239, respectively).

Conclusions: On-site pharmacies may provide an opportunity to positively impact retention in care and clinical outcomes for PLWH.

Keywords: HIV; adherence; pharmacy; retention in care; viral load.

MeSH terms

  • Anti-HIV Agents* / therapeutic use
  • HIV Infections* / drug therapy
  • Humans
  • Outpatients
  • Pharmacies*
  • Pharmacy*
  • Retention in Care*
  • Retrospective Studies

Substances

  • Anti-HIV Agents