Role of pharmacists in promoting patient adherence to antiretroviral drugs

Background: Though pilot studies show that pharmacists can help improve patient adherence, their role in promoting adherence in clinical practice is less well understood. Methods: We conducted 30 face-to-face interviews with HIV trained pharmacists in retail and specialty pharmacies, located in 4 Midwestern cities. We asked pharmacists about their procedures, how they promote patient adherence, and the challenges they face in their efforts to promote patient adherence to antiretroviral drugs. Results: Specially trained pharmacists reported several strategies for promoting patient adherence: 1) delivering medications at no additional cost to patients; 2) providing manufacturer coupons to patients with no insurance; 3) providing patient education (on medication adherence and drug resistance) and adherence tools (e.g., pill organizers and timers); 4) conducting antiretroviral side-effects management; 5) following-up with patients on a routine basis; 6) helping design individualized drug regimens; and 7) providing emotional support to patients. Nonspecialty pharmacists did not report providing other services to patients in addition to dispensing antiretrovirals, citing time and logistical constraints. Nevertheless, pharmacists expressed an interest in doing more to promote patient adherence. Conclusion: Specially trained pharmacists provide a number of pharmaceutical services in addition to dispensing prescriptions. These pharmacists are actively involved in addressing patient barriers and proactively promoting adherence to antiretrovirals. Specially trained pharmacists in both retail and specialty pharmacies are well positioned to promote patient adherence given their accessibility, trust in the community and training in pharmacology, and can play a vital role in ensuring that HIV-positive individuals live long, high quality lives.