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.
N1 - Funding Information:
The authors thank all the members of the Patient-Centered HIV Care Model team: Michael Aguirre, Osayi Akinbosoye, David M. Bamberger, Ben Bluml, Katura Bullock, Diane C. Burrell, Tim Bush, Clifton Bush, Kathy K. Byrd, Chad Cadwell, Nasima M. Camp, Roberto Cardarelli, Terri Clark, Patrick G. Clay, Andrew Crim, Angela Cure, Kristin Darin, Traci Dean, W. Ambrose Delpino, Michael DeMayo, Shara Elrod, Ashley L. Eschmann, David Farmer, Rose Farnan, Heather Free, Andrew Gudzelak, Andrew Halbur, Felecia Hardnett, Ronald Hazen, Heidi Hilker, John Hou, Brian Hujdich, Lisa Johnson, Heather Kirkham, James Lecounte, Sayuri Lio, Guanzhong Lo, Sondra Middleton, Brittany Mills, Christopher M. Nguyen, Linda Ortiz, Glen Pietrandoni, Kim Scarsi, Jon Schommer, Michael D. Shankle, Ram Shrestha, Daron Smith, Sumihiro Suzuki, Michael S. Taitel, Gebeyehu N. Teferi, Vi-kas Tomer, Louis Terres, Paul J. Weidle, Carmelita Whitfield, and Jason E. Willman. This work was supported by the Secretary’s Minority AIDS Initiative fund and the Centers for Disease Control and Prevention (CDC) through a cooperative agreement (CDC RFA PS13-1315) with the University of North Texas Health Science Center’s System College of Pharmacy. Walgreens Co. provided all services in-kind.
Publisher Copyright:
© 2019, Mary Ann Liebert, Inc., publishers.
PY - 2019/2
Y1 - 2019/2
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.
KW - HIV
KW - care continuum
KW - pharmacists
KW - retention
UR - http://www.scopus.com/inward/record.url?scp=85061162341&partnerID=8YFLogxK
U2 - 10.1089/apc.2018.0216
DO - 10.1089/apc.2018.0216
M3 - Article
C2 - 30648888
AN - SCOPUS:85061162341
SN - 1087-2914
VL - 33
SP - 58
EP - 66
JO - AIDS Patient Care and STDs
JF - AIDS Patient Care and STDs
IS - 2
ER -