The Role of the Pharmacist in the Management of HIV/AIDS
Anthony J. Zappa
HIV/AIDS currently affects about 31 million people worldwide. Many infected people do not receive proper care because of a lack of resources or education about current treatment options. Even where treatments are available, they are often not optimal because of poor adherence, adverse events or resistance. In developed countries, HIV/AIDS is quickly becoming a chronic disease requiring long term care. Disease management concepts are being adapted to this disease, but are not yet fully successful because of the lack of definitive guidelines and disjointed delivery of care. Also, alternative caregivers have not been actively recognised by traditional providers, resulting in even less continuity of care. A new community-based model for healthcare delivery for people with HIV/AIDS is required. A potential model uses the pharmacy, now termed a community care centre, as the focal point for care delivery. A new healthcare team, including a doctor/physician, pharmacist and nutritionist would coordinate treatment selection and delivery. Other healthcare providers could be added as required. In addition, the pharmacist would act as a data manager for the team. They would collect and report data on medication and over-the-counter drug usage, compliance, adverse events and lifestyle behaviours. These data would be provided to other team members in real-time to create a coordinated management plan. The pharmacist would also act as a community resource for information on HIV/AIDS to help dispel myths and misinformation about the disease. They can be a provider of testing services and counselling, as well as preventative methods and information. This model is being discussed and implemented by a small number of providers in the US. Considerable study will be required to prove its economic and therapeutic value to HIV/AIDS treatment.
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