Efficacy of a novel spreadsheet program for pharmacy-based antiretroviral (ARV) monitoring in Southern Africa
I. Ichile1,2, N. Butts1, J. Holmes1, J. Alexander1, J. Barone1, H. Jimenez1
1Rutgers The State University of New Jersey, Ernest Mario School of Pharmacy, Piscataway, United States, 2Secure the Future, Johannesburg, South Africa
Issues: Government-led efforts have expanded HIV medication access to rural populations in southern Africa. However, limited medication choices subject patients to high side effect profiles, and require more efficient drug monitoring. Most clinics have underdeveloped monitoring programs, as limited pharmacy resources have funneled efforts toward more urgent functions like dispensing and stock management. A unique pharmacy practice residency was created by Rutgers University and a global pharmaceutical company´s philanthropic foundation to study and assist in the delivery of enhanced pharmacy services to HIV patients. This abstract describes an innovative spreadsheet program, created by the resident, and utilized by pharmacy staff to facilitate ARV monitoring.
Description: The PharmD resident developed a structured tool, featuring a user-friendly spreadsheet. The spreadsheet was incorporated into the pharmacy staff's daily routine to address regular drug monitoring shortfalls. Data was entered into the tool for each visiting patient (e.g. prescribed ARV medication(s) and dose, pill count from last fill, drop-down list of common adverse events, and last CD4 count and viral load in medical record). An internal adherence calculator and medication/population tracking option were additional capabilities that enhanced patient safety. To support optimal usage, an on-site modular learning program was developed and implemented, with an accompanying operations manual.
Lessons learned: The ARV monitoring tool enabled pharmacy staff to easily and routinely obtain key information to make a complete assessment of a patient's drug therapy. Moreover, continuous use of the tool stimulated more efficient and individualized counseling. Input from both user and developer was critical to the development of a successful ARV drug monitoring tool, which must be customized to meet the unique needs of different sites.
Next steps: Sustained success of the ARV monitoring spreadsheet program will require a continuous improvement program based on user feedback and persistence in providing appropriate staff training.
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