Impacto do serviço de dispensação de medicamentos sobre desfechos de saúde de pessoas vivendo com HIV

Abstract

Introduction: Inadequate patient knowledge about their medications and non adherence to antiretroviral therapy (ART) can negatively impact the health outcomes of people living with HIV (PLHIV). Although the literature highlights the positive impact of clinical services provided by pharmacists in improving knowledge and adherence to ART, little is known about the influence of the dispensing service on these outcomes. Objective: To evaluate the impact of the antiretroviral dispensing service on the knowledge and adherence of PLHIV to ART. Method: A before-and-after study was conducted from August 2023 to June 2024 at the Medication Dispensing Unit at a teaching hospital with PLHIV who met the eligibility criteria. The intervention consisted of providing drug dispensing according to protocol. Sociodemographic and clinical data were collected, and knowledge and medication adherence were assessed using validated instruments at two points: t0 (before the intervention) and t1 (four to eight weeks after the intervention). Data was processed using descriptive and inferential statistical analysis. The study was approved by the Research Ethics Committee of the Federal University of Espírito Santo (CAAE: 77675624.3.0000.5060). Results: A total of 148 PLHIV participated in the study, the majority of whom were male (n=96; 64,86%), with a mean age of 49±12.08 years. After the intervention, a significant improvement in knowledge scores was observed (before 1.17 ± 0.31, and after 1.79 ± 0.16, p<0.001 d=-2.13), as much as in adherence to ART (before 78.51 ± 4.50, and after 83.84 ± 3.91, p<0.001, d=-1.32). After dispensing, the rate of patients with absent or insufficient knowledge decreased by almost 60%, and the rate of patients with insufficient adherence decreased by almost 16%. Conclusion: This study showed that drug dispensing significantly improved the knowledge and adherence of PLHIV to ART. These results may be useful in guiding policies and guidelines for research and practice related to ART dispensing