PMID- 33666264
OWN - NLM
STAT- MEDLINE
DCOM- 20211203
LR  - 20211214
IS  - 1365-2710 (Electronic)
IS  - 0269-4727 (Linking)
VI  - 46
IP  - 4
DP  - 2021 Aug
TI  - Clinical outcomes of pharmaceutical care intervention in HIV positive patients 
      with hypertension: A randomized controlled study.
PG  - 1083-1094
LID - 10.1111/jcpt.13400 [doi]
AB  - WHAT IS KNOWN AND OBJECTIVE: Pharmaceutical care (PC) has been shown to improve 
      clinical outcomes in hypertensive patients as well as in people living with HIV 
      (PLWHV). The objective of this study was to evaluate the impact of PC on blood 
      pressure (BP) control, viral load and adherence to medications in hypertensive 
      PLWHV. METHODS: This was a prospective, randomized controlled study conducted in 
      the University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria. Eligible 
      ambulatory patients were randomized equally to two study arms. The control arm 
      (CA) received the traditional care offered at the HIV clinic; the intervention 
      arm (IA) received the traditional care in addition to PC by the research 
      pharmacist, which included structured education/counselling. BP and self-reported 
      medication adherence were measured at baseline, 6 months and 12 months. Viral 
      load was obtained at baseline and after 12 months. Data were analysed with spss, 
      version 25.0. RESULTS AND DISCUSSION: Of the 206 participants initially 
      randomized, 182 (91 in each study arm) completed the 12-month follow-up. No 
      significant differences existed in both arms concerning 
      socio-demographic/clinical characteristics of participants at baseline 
      (p > 0.05). After 12 months, BP control was significantly higher in the IA (53.4% 
      vs. 25.2%; p < 0.001, adjusted odds ratio, aOR = 3.20 (95% CI 1.59-6.44). 
      Systolic BP reduced by 0.9 mmHg from baseline in the CA (p = 0.668) and by 
      16.67 mmHg from baseline value in the IA (p < 0.001). Diastolic BP increased by 
      1.9 mmHg in the CA (p = 0.444), but reduced by 7.0 mmHg in the IA (p < 0.001). No 
      significant differences were observed in the change from baseline in the 
      proportion with undetectable plasma viral load (UPVL) in both groups (p > 0.05). 
      PC led to an increase in mean adherence to antiretroviral drugs (Delta = 0.55; 
      p = 0.015), and an increase in mean adherence to antihypertensive drugs 
      (Delta = 2.32; p < 0.001) in the IA. WHAT IS NEW AND CONCLUSION: To our knowledge, 
      this is the first prospective randomized controlled study evaluating the impacts 
      of PC on clinical outcomes in hypertensive PLWHV with a 12-month follow-up. Our 
      results show that PC significantly improved BP control and adherence to 
      antiretroviral and antihypertensive medications, but had no significant effect on 
      viral load in HIV positive patients with hypertension. Providers of care for 
      PLWHV should leverage the established HIV treatment successes for promoting 
      adherence to treatment for common comorbidities like hypertension in PLWHV in 
      order to improve clinical outcomes.
CI  - (c) 2021 John Wiley & Sons Ltd.
FAU - Jackson, Idongesit L
AU  - Jackson IL
AUID- ORCID: 0000-0003-3460-7233
AD  - Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Uyo, Nigeria.
FAU - Ukwe, Chinwe V
AU  - Ukwe CV
AD  - Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, 
      Nsukka, Nigeria.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20210305
PL  - England
TA  - J Clin Pharm Ther
JT  - Journal of clinical pharmacy and therapeutics
JID - 8704308
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (Antihypertensive Agents)
SB  - IM
MH  - Adult
MH  - Anti-Retroviral Agents/administration & dosage/*therapeutic use
MH  - Antihypertensive Agents/administration & dosage/*therapeutic use
MH  - Blood Pressure
MH  - Counseling/organization & administration
MH  - Female
MH  - HIV Infections/*drug therapy
MH  - Hospitals, Teaching
MH  - Humans
MH  - Hypertension/*drug therapy
MH  - Male
MH  - Medication Adherence/statistics & numerical data
MH  - Middle Aged
MH  - Nigeria
MH  - Patient Education as Topic/organization & administration
MH  - Pharmaceutical Services/*organization & administration
MH  - Prospective Studies
MH  - Socioeconomic Factors
MH  - Viral Load
OTO - NOTNLM
OT  - HIV
OT  - comorbidity
OT  - hypertension
OT  - pharmaceutical care
OT  - randomized controlled trial
EDAT- 2021/03/06 06:00
MHDA- 2021/12/15 06:00
CRDT- 2021/03/05 08:39
PHST- 2021/02/11 00:00 [revised]
PHST- 2021/01/22 00:00 [received]
PHST- 2021/02/13 00:00 [accepted]
PHST- 2021/03/06 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/03/05 08:39 [entrez]
AID - 10.1111/jcpt.13400 [doi]
PST - ppublish
SO  - J Clin Pharm Ther. 2021 Aug;46(4):1083-1094. doi: 10.1111/jcpt.13400. Epub 2021 
      Mar 5.