一般論文
HIV外来診療における協働意思決定に基づいた継続的な薬剤師介入の影響
2023 年 49 巻 2 号 p. 39-50
詳細
2023 年 49 巻 2 号 p. 39-50
Recently, the effectiveness of shared decision-making (SDM) for adherence, such as improvement of patients’ motivation for treatment and reduction in missing a dose, has been reported. The purpose of this study was to analyze the result of SDM-based continuous pharmacist intervention in outpatients with HIV. The single-center retrospective study was conducted at Niigata University Medical and Dental Hospital, which was the AIDS treatment center hospital in the Kanto region. We collected information from electronic medical records and performed analysis of 49 outpatients who regularly visit the hospital and are undergoing ART.
Pharmacists worked with the patients and their physicians to select medications that were optimal in terms of efficacy, avoiding DDIs, and patient tolerability. Adverse events were the most common reason for a change of prescription, followed by reducing the burden of taking medication and DDIs. The prescription changes succeeded in optimization of ART regimens in accordance with guidelines and psychotropic medications (significant reduction in the number of tablets and types of medication), which resulted in contribution to hospital income by incentive medical fees due to the avoidance of polypharmacy. The findings indicate that continuous SDM-based pharmacist interventions in outpatients with HIV were effective for not only optimization of the ART regimen and improvement of polypharmacy but also economic benefits.
