The Role of the Clinical Pharmacist in the Management of People Living with HIV in the Modern Antiretroviral Era

Abstract

As the HIV epidemic has evolved, so too has the role of the clinical pharmacist (CP) in the management of people living with HIV (PLWH). The modern antiretroviral therapy (ART) era has resulted in PLWH living normal life spans with resulting increased comorbidities. CPs have long been a part of the multidisciplinary management of ART. However, with the changing demographics of PLWH and health-care system dynamics, CPs have had the opportunity to expand their role. This includes involvement in managing increasing comorbidities with expanding and more complicated medication regimens, drug interaction monitoring, and optimizing transitions of care, all while recognizing and addressing barriers to successful HIV and hepatitis C virus (HCV) treatment. In addition, with the expansion of HIV prevention and pre-exposure prophylaxis (PrEP) services, CPs have the opportunity to be involved in HIV prevention. This study summarizes the literature evaluating the impact of CPs in the management of PLWH in the era of modern ART. We conducted a literature search to identify studies that assessed the CP role in HIV clinical practice since 2006. The identified studies were grouped into two categories. The first was HIV related outcomes, including interventions on regimen selection, adherence, regimen optimization, and management of treatment failure. The second group of studies pertained to aging and vulnerable populations, including management of comorbidities, transitions of care, medication-assisted treatment, hepatitis C, and HIV screening and PrEP. We concluded that the evidence supports the expanding role of CPs to positively impact a variety of aspects related to the care of PLWH.