Beyond Pill-Counting: Effect of Pharmacist Counseling on Antiretroviral Adherence

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DESCRIPTION (provided by applicant): This is a resubmission for a K23 award for Dr. Jennifer Cocohoba, an HIV Pharmacist and Associate Clinical Professor at the University of California, San Francisco. Dr. Cocohoba is establishing herself as a young investigator in patient-oriented research. She is interested in evidenced-based methods by which pharmacists can improve medication adherence for chronic diseases, particularly for patients with HIV. This K23 award will provide Dr. Cocohoba with the necessary support to accomplish the following goals: (1) to conduct quantitative, qualitative, and interventional studies that seek to understand and measure the impact pharmacists have on antiretroviral adherence; (2) to implement advanced biostatistical methods in clinical studies; and (3) to develop an independent, patient-oriented, clinical research career studying medication adherence. To achieve these goals, Dr. Cocohoba has assembled a mentoring team comprised of a primary mentor, Dr. Ruth Greenblatt, principal investigator of the San Francisco site of the Women's Interagency HIV Study, who conducts research on the effects of HIV on women; a co-mentor, Dr. Mallory Johnson, Associate Professor at the UCSF Center for AIDS Prevention Studies who conducts interventional studies to improve antiretroviral adherence; and two scientific advisors: Dr. Peter Bacchetti, an expert on study design and state- of-the-art biostatistical methods, and Dr. Megan Comfort, an expert in qualitative research. Dr. Cocohoba's long-term goal is to enhance the impact pharmacists have on improving adherence to medications. The objective of this application is to assess the multiple sociodemographic and pharmacy factors associated with receipt of pharmacist adherence counseling (Aim 1); to understand the pharmacist- patient adherence counseling dynamic (Aim 2); and to measure the impact counseling has on HIV treatment outcomes by conducting a pilot study of a pharmacist-delivered, telephone counseling intervention based on the Information-Motivation-Behavior model. (Aim 3). This research will form the basis of a randomized interventional trial that will be submitted in an R01 grant application before the end of the K award. PUBLIC HEALTH RELEVANCE: There is a critical need to develop simple methods that utilize novel human and physical resources to improve adherence to antiretroviral therapy. Pharmacists remain a large, untapped resource for HIV treatment advocacy. Engaging pharmacists to effectively counsel on adherence may result in an improvement in HIV treatment effectiveness and reduction in HIV viral resistance and transmission.