A pharmacist-led medication switch protocol in an academic HIV clinic: patient knowledge and satisfaction

Abstract

Background: Tenofovir alafenamide (TAF) is associated with less renal and bone toxicity compared with tenofovir disoproxil (TDF). TAF's recent FDA approval has spurred HIV providers to consider switching antiretroviral therapy (ART) regimens containing TDF to TAF to minimize long term risks. Patient views on the process of such medication switches have not been explored.

Methods: Patients taking elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (E/C/F/TDF) following the Food and Drug Administration's (FDA) approval of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) received medication education from an HIV pharmacist prior to switching to the tenofovir alafenamide (TAF) formulation. Patients were asked to complete a cross-sectional survey assessing satisfaction with the switch process and knowledge about the new medication 4 to 8 weeks post-switch.

Results: Sixty five patients completed the switch and 57 (88%) completed a follow-up survey. Most (86%) reported understanding why the switch was made, while 91% correctly identified that TAF is associated with reduced renal toxicity, and 73% correctly identified that TAF is associated with reduced bone toxicity. No statistically significant difference was found in satisfaction with or understanding of why the medication switch was made when assessed by sex, age, race, or education, but there was a trend toward significance in the distribution of answers based on education level with those with a high school diploma, General Educational Development (GED) or less being more likely to be satisfied with the medication switch (p = 0.074).

Conclusions: Education from an ambulatory clinic-based HIV pharmacist resulted in high rates of patient satisfaction and understanding of the switch from TDF to TAF-containing ART.

Keywords: HIV infection; Medication switch; Patient knowledge and attitudes; Pharmacist; Survey.

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Institutional Review Board of the University of Nebraska Medical Center, IRB number 637–15. Exemption from written informed consent was granted and a cover letter informing participants about the study was attached to each survey.

Consent for publication

N/A

Competing interests

SHB reports research grants to her institution from Gilead Sciences, for this work. SS reports research grants to her institution from ViiV and Merck. The other authors declare that they have no competing interests.

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