Using an ambulatory clinic-based HIV pharmacist for education during a switch from elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (TDF) to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (TAF) can boost patient satisfaction and understanding for the change in therapy, according to recent research published in BMC Infectious Diseases.
Pharmacists have increasingly been beneficial in many community and HIV-related settings. Previous research established that a pharmacist-led change in statin use resulted in more people being satisfied with the switch.
Study authors examined participant knowledge and opinions about switching from TDF to TAF. They hypothesized that switches involving pharmacist-led protocols would show high levels of satisfaction and understanding.
All participants attended the University of Nebraska Medical Center HIV clinic and were switching from TDF to TAF. The clinical pharmacist approached potential participants at the time of their medical appointments or contacted them by phone in order to discuss the switch.
Participants were given choices about how to receive their information (phone, face-to-face, both). The pharmacist reviewed medication interactions, provided counseling and education, and prescriptions. The pharmacist also updated the medical record. Between 4 to 8 weeks after interacting with the pharmacist, participants took an 18-item survey that noted their knowledge and opinions about switching from TDF to TAF.
A total of 65 people switched medications during the study period. Results are based from the 88% (n=57) who completed the follow-up survey. The majority of the participants (86%) understood why they were changing medication, 91% expressed knowledge about TAF and its association with renal toxicity reductions, and 73% identified the association between TAF and reductions in bone toxicity.
Study authors also noted a trend approaching statistical significance regarding education level and satisfaction with the medication switch (P = 0.074). People with a high school diploma, GED, or less tended to be more satisfied with switching from TDF to TAF. The study produced no other trends toward significance for other demographics like sex, age, or race.
Study limitations include generalizability issues due to the study’s single-site design, and gender and age disparities. Also, because respondents could complete the survey in-person or by phone, there may have been variability in understanding survey questions and reporting.
Study authors concluded that “high rates of satisfaction and knowledge in this pharmacist-led medication switch protocol suggest that pharmacists could lead similar medication switches in the future yielding similar results, and face-to-face consultation should be considered given patient preference for this mode.”
This study was funded by Gilead Sciences, Inc. Please refer to reference for a complete list of authors’ disclosures.
Lee SS, Havens J, Sayles HR, et al. A pharmacist-led medication switch protocol in an academic HIV clinic: patient knowledge and satisfaction. BMC Infectious Diseases. 2018; 18(1):310. doi: 10.1186/s12879-018-3226-2