Drug related problems associated with anti-retroviral therapy of HIV/AIDS patients at Ndola Central Hospital

Abstract

Background: Antiretroviral therapy has posed multiple risks and challenges particularly in resource constrained African countries. This is due to the chronic nature of HIV/AIDS disease and hence its therapy, the use of combination therapy and also because therapeutic options and treatment guidelines continue to evolve. The increase in access to new essential medicines such as ARVs and the ARV regimen complexity and challenges increase the potential for drug related problems. Objective: To determine the prevalence and patterns of drug related problems associated with anti-retroviral drugs in the management of HIV/AIDS patients at Ndola Central Hospital in 2016. Methodology: A retrospective cross sectional study design involving 300 randomly sampled HIV positive patients admitted to the internal medicine wards of Ndola Central Hospital was conducted. The actual/potential patient specific ARV drug related problems were identified and classified according to the Pharmaceutical Care Network Europe (PCNE) V5.01 for drug related problems. The ARV drug classes associated with the drug related problems were also determined as well as the intervention rate against these drug related problems. This was achieved by review of patients’ files and drug charts over a period of two months. The data from the research was analyzed using SPSS 20.0 version. Descriptive and inferential statistics such as frequency tables, percentages and chi square tests were performed.

Results: Out of 300 patients involved in the study, 31% had drug related problems associated with antiretroviral drugs in the management of HIV/AIDS patients. The prevalence of each Drug related problem in the management of HIV/AIDS patients were adverse drug event (40%), Non-compliance (40%) and no drug initiation (20%). Only the ARV drug class NRTIs, was significantly associated with adverse drug event and Noncompliance with p values= 0.03 and 0.011 respectively. The rate of intervention to prevent or resolve drug related problems associated with HIV/AIDS patients was 24 %.

Conclusion: The study revealed a high prevalence of DRPs with a risk of DRPs being high in patients taking NRTIs. The Antiretroviral drug related problems identified in the study were adverse drug event (40%), Non-compliance (40%) and No Antiretroviral drug initiation (20%). There was a low rate intervention in these DRPs and this can lead to the development of ARV resistance and treatment failure over time.