title: Integration among hospital pharmacists and infectious diseases physicians in the outpatient management of HIV infection.
abstract: Permanent monitoring of adherence to combination antiretroviral therapy (cART), together with the assessment and management of related adverse events, plays a key role for optimised management of HIV infection. In our HIV outpatient clinic a dedicated pharmacist provides direct drug distribution and accountability, and gives information on administration mode, possible side effects and drug interactions. A survey card regarding cART adherence and adverse drug reactions (ADRs) is administered to all patients. All figures are recorded in an electronic database. In an ad interim analysis 659 consecutive patients' data were evaluated, of whom 74% were fully adherent to cART. A lower adherence rate was found to be correlated with the presence of concurrent medications, and with the increasing number of daily cART tablets/capsules. A significant impact of cART adherence on a favourable course of the main laboratory surrogate markers of HIV disease progression (CD4+ T-lymphocyte count and HIV viral load) was also observed. Darunavir-containing cART was related to a lower incidence of early gastrointestinal and neuropsychiatric disturbances and also a reduced perception of morphological/physical changes. A multidisciplinary approach based on strict interaction between pharmacists and infectious diseases physicians may significantly improve cART adherence and the monitoring of adverse events, making a considerable contribution to the better management of HIV-infected patients.
authors.affiliation: Hospital Pharmacy, S. Orsola Malpighi Hospital; Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Appolloni
authors.affiliation: Hospital Pharmacy, S. Orsola Malpighi Hospital; Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Locchi
authors.affiliation: Hospital Pharmacy, S. Orsola Malpighi Hospital; Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Girometti
authors.affiliation: Hospital Pharmacy, S. Orsola Malpighi Hospital; Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calza
authors.affiliation: Hospital Pharmacy, S. Orsola Malpighi Hospital; Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Colangeli
authors.affiliation: Hospital Pharmacy, S. Orsola Malpighi Hospital; Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredi
authors.affiliation: Hospital Pharmacy, S. Orsola Malpighi Hospital; Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Magistrelli
authors.affiliation: Hospital Pharmacy, S. Orsola Malpighi Hospital; Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Filomena
authors.initials: F
authors.lastname: Piro
authors.affiliation: Hospital Pharmacy, S. Orsola Malpighi Hospital; Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Viale
authors.affiliation: Hospital Pharmacy, S. Orsola Malpighi Hospital; Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Puggioli
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D010045:Outpatients; D010348:Patient Care Team; D010349:Patient Compliance; D010607:Pharmacy Service, Hospital; D011795:Surveys and Questionnaires
chemical_list: D044966:Anti-Retroviral Agents