The impact of the checklist implementation, real-time traceability and patient communication strategy (HELIOS-TEST) on the adherence to antirretroviral therapy in different provinces of Argentina

Abstract

Access to antiretroviral treatment (ART) is one of the fundamental basis for the control of the HIV/AIDS epidemic at local, regional and global levels. This is part of the strategic “90-90-90” objectives proposed for the year 2020. To achieve these goals, pharmacy teams play a key role in the timely provision of ART under strict traceability standards and quality controls. Considering this need, we have developed a program for dispensing and monitoring its adherence (HELIOS-TEST). The objective of this study was to evaluate the implementation and impact of this strategy made by a national drugstore (Helios Pharma SA.) on the adherence to this treatment in patients with health coverage that reside in the interior of the country. For this purpose, a retrospective analytical study was performed including all the patients with prescription of ART from the year 2015 to 2018 inclusive (InfHos system). The proportion of adherence, defined by pharmacy withdrawals and viral suppression, was evaluated before (2016) and after (2018) the implementation of the mentioned strategy in 2017. The Z test was applied to evaluate differences in proportions and a value of p <0.05 was considered significant. In 2016, adherence was at 86.7% (n = 2030), while in 2018, it was detected at 98% (n = 2907), with a significant increase of 10.3% after the implementation of HELIOS-TEST (p <0.001; 95% CI: 9.65% - 12.86%). With respect to viral suppression, the proportion of patients with undetectable viral load was 77% in 2016 and 87% in 2018, corresponding to an increase of 10% (p <0.001; 95% CI 8-12%). This strategy had a significant impact on the adherence to ART and virologic suppression.