The effect of clinical pharmacy care of patients with HIV in Anti-retroviral clinic, Chaturapakphiman hospital, Roi-et Province

Abstract

Purposes : To examine the existing problems, develop a care model, and evaluate the outcomes of pharmaceutical care for patients living with HIV and AIDS.

Study Design : Action research.

Materials and Methods: A prospective study was conducted from October 1, 2024, to March 31, 2025, at the antiretroviral (ARV) clinic of Chaturaphak Phiman Hospital. A total of 103 patients who had been on antiretroviral therapy (ART) for at least six months were enrolled. Data collection tools included structured interviews, adherence records, and validated knowledge tests with content validity indices ranging from 0.67 to 1.00. Statistical analyses included the Wilcoxon signed-rank test, Shapiro-Wilk test, and Maxwell-Stuart test.

Main findings : Among the 103 patients receiving continuous care, a total of 50 drug-related problems (DRPs) were identified. The most frequent issue was non-adherence to ART, accounting for 39 cases (78%). Adverse drug reactions were observed in 6 cases (12%), primarily due to decreased eGFR (<50 mL/min/1.73 m²). The number of patients achieving an adherence score above 95 increased from 94 (91.26%) before pharmaceutical care to 96 (93.2%) after the intervention, showing a statistically significant improvement (p = .044). The mean CD4 cell count significantly increased from 491.83 ± 245.32 cells/mm³ to 555.96 ± 229.45 cells/mm³  (p < .001). Additionally, the proportion of patients with viral load <20 copies/mL increased by 4.71% post-intervention.

Conclusion and Recommendations: Pharmaceutical care provided at the ARV clinic of Chaturaphak Phiman Hospital effectively addressed medication-related problems and enhanced adherence to ART among patients with HIV. The intervention also improved patient understanding, safe medication use, and clinical outcomes. These findings support the integration of pharmaceutical care into routine HIV services to optimize long-term treatment success.