Federal Bureau of Prisons HIV consultant pharmacist monitoring and advisory program.

OBJECTIVE

To present outcomes resulting from the implementation of a pharmacist-run human immunodeficiency virus (HIV) medication management model.

SETTING

Federal Bureau of Prisons (BOP) from December 2004 to December 2009.

PRACTICE DESCRIPTION

The BOP instituted the National HIV Clinical Pharmacist Consultant (NHCPC) program in December 2004. NHCPCs monitor and provide guidance as to the appropriateness of antiretroviral therapy (ART) throughout the BOP. They also serve as readily accessible resources for all BOP providers, having the training and expertise necessary to affect positive patient outcomes. NHCPCs were provided intensive training through a Johns Hopkins University HIV/acquired immunodeficiency syndrome pharmacotherapy traineeship administered by the American Society of Consultant Pharmacists and have AAHIVE (HIV Expert) credentialing.

PRACTICE INNOVATION

NHCPCs monitor HIV therapy and patient outcomes via BOP electronic medical records.

MAIN OUTCOME MEASURES

The vision for this program encompasses an overall healthier BOP HIV patient population being treated in accordance with current Department of Health & Human Services guidelines. Specifically, all patients taking ART have the goals of (1) achieving undetectable viral loads (≥70%), (2) maintaining CD4 T-cell counts of 200 cells/mm3 or more (≥70%), and (3) taking at least 90% of prescribed doses.

RESULTS

From April 2004 to December 2009, the overall percentage of BOP patients with undetectable viral loads increased from 32% to 66%. As of December 2009, 76% of patients receiving ART achieved CD4 counts of 200 cells/mm3 or greater and 73% were taking 90% or more of prescribed doses.

CONCLUSION

The NHCPC program lends credence to the value of pharmacists in improving patient outcomes.