Retention in HIV Care among Participants in the Patient-Centered HIV Care Model: A Collaboration between Community-Based Pharmacists and Primary Medical Providers

Kathy K. Byrd, Felicia Hardnett, Patrick G. Clay, Ambrose Delpino, Ron Hazen, Michael D. Shankle, Nasima M. Camp, Sumihiro Suzuki, Paul J. Weidle

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)58-66
Number of pages9
JournalAIDS Patient Care and STDs
Volume33
Issue number2
DOIs
StatePublished - Feb 2019

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Patient-Centered Care
Pharmacists
HIV
Odds Ratio
Confidence Intervals
Morbidity
Mortality

Keywords

  • HIV
  • care continuum
  • pharmacists
  • retention

Cite this

Byrd, Kathy K. ; Hardnett, Felicia ; Clay, Patrick G. ; Delpino, Ambrose ; Hazen, Ron ; Shankle, Michael D. ; Camp, Nasima M. ; Suzuki, Sumihiro ; Weidle, Paul J. / Retention in HIV Care among Participants in the Patient-Centered HIV Care Model : A Collaboration between Community-Based Pharmacists and Primary Medical Providers. In: AIDS Patient Care and STDs. 2019 ; Vol. 33, No. 2. pp. 58-66.
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Retention in HIV Care among Participants in the Patient-Centered HIV Care Model : A Collaboration between Community-Based Pharmacists and Primary Medical Providers. / Byrd, Kathy K.; Hardnett, Felicia; Clay, Patrick G.; Delpino, Ambrose; Hazen, Ron; Shankle, Michael D.; Camp, Nasima M.; Suzuki, Sumihiro; Weidle, Paul J.

In: AIDS Patient Care and STDs, Vol. 33, No. 2, 02.2019, p. 58-66.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Retention in HIV Care among Participants in the Patient-Centered HIV Care Model

T2 - A Collaboration between Community-Based Pharmacists and Primary Medical Providers

AU - Byrd, Kathy K.

AU - Hardnett, Felicia

AU - Clay, Patrick G.

AU - Delpino, Ambrose

AU - Hazen, Ron

AU - Shankle, Michael D.

AU - Camp, Nasima M.

AU - Suzuki, Sumihiro

AU - Weidle, Paul J.

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N2 - 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.

AB - 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.

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