Potential roles of pharmacists in HIV/AIDS care delivery in Nepal: A qualitative study.

Abstract

Nepal is facing escalating infection rates of HIV/AIDS, a major global public health threat. Continuum of services is an identified strategic component of Joint United Nations Programme on HIV/AIDS (UNAIDS) commitment to end this public health crisis by 2030 and achieve the Sustainable Development Goal 6 (SDG 6). Pharmacists are integral members of the continuum of care in HIV/AIDS but the idea is novel to Nepal. Realizing need to explore and identify potential roles of pharmacists in HIV/AIDS care delivery, this study aimed to gain an insight into the views of stakeholders on the roles of pharmacists in this arena. A qualitative approach was used where 14 key informants were interviewed using a semi-structured interview protocol. Participants were selected through a sequence of purposive sampling and snowball sampling technique. The interviews were conducted, transcribed verbatim and analyzed using thematic analysis. Potential roles of pharmacists reside in adherence monitoring, pharmacovigilance, provincial and district level ART centers. Pharmacists and other stakeholders held divergent views on the pharmacist's role in dispensing and counseling antiretroviral medications. Barriers to the pharmacists' involvement were lack of workforce, advocacy and government support, frailty of professional organizations, self-limited scope, policy constraints, structural limitations, biasedness, and societal unawareness. Pharmacists themselves and organizations such as National Government Organizations (NGOs) and International Government Organizations (INGOs) were identified as the facilitators. Stakeholders are willing to expand role of pharmacists in HIV/AIDS care in Nepal. Nevertheless, some crucial impediments exist. Primarily, an aggressive and assertive advocacy is needed from pharmacists themselves and their professional organizations to establish their roles in HIV/AIDS care delivery. Additionally, unearthing potential of pharmacists as contributors in HIV/AIDS care delivery or any other chronic disease management equally demands a strong support from the government officials as well as the other health care professionals.