Resumen

BRONKHORST, Elmien; HATTINGH, Sonja  y  POKA, Madan. Antiretroviral stewardship in a tertiary academic hospital: The need for a clinical pharmacist. Health SA Gesondheid (Online) [online]. 2023, vol.28, pp.1-7. ISSN 2071-9736.  http://dx.doi.org/10.4102/hsag.v28i0.2135.

BACKGROUND: South Africa has the highest prevalence of people living with HIV globally. Although antiretroviral therapy provides solutions, evidence of antiretroviral resistance emerged, requiring the application of antiretroviral-stewardship programmes to curb medication-related problems AIM: Identify and describe antiretroviral-stewardship pharmacist interventions in an active antiretroviral-stewardship programme SETTING: HIV-positive adults admitted to medical wards at a tertiary academic hospital in South Africa METHODS: A descriptive quantitative study was performed, utilising an antiretroviral-stewardship assessment tool to determine antiretroviral-related recommendations in the treatment of HIV-positive adults. The study employed purposive sampling. Treatment charts were evaluated to identify antiretroviral-stewardship recommendations. The number of recommendations highlighted the need for a clinical pharmacist in an active antiretroviral-stewardship programme. Descriptive data analysis with Pearson correlations was employed to display the data RESULTS: Medication-related problems were identified in 100% of study patients (n = 41), with an average of 2.46 interventions per patient. One-hundred-and-one medication-related problems were identified by using the antiretroviral-stewardship assessment tool. The identified problems included a lack of viral load testing (41, 100%), lack of CD4 count monitoring (15; 36.6%) and lack of prophylactic treatment against opportunistic infections (10; 24.4%). Medication-related problems included the presence of clinically significant drug-drug interactions and serious side effects, CD4 count decline despite being on antiretroviral therapy, unnecessary treatment interruptions including risk for IRIS, inappropriate antiretroviral therapy regimen, non-adherence and absence of treating tuberculosis as co-morbidity CONCLUSION: Present study demonstrates the need of an active antiretroviral-stewardship programme's benefits. The possible role of the clinical pharmacist as active participant and leader in this programme is highlighted CONTRIBUTION: Highlight the role of clinical pharmacists in antiretroviral stewardship

Palabras clave : HIV; antiretroviral stewardship; clinical pharmacist; antiretroviral therapy; Interventions; antiretroviral stewardship; clinical pharmacist; antiretroviral therapy.

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