Correlates of one-year mortality among patients living with HIV according to the stratification level of the pharmaceutical care model

IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Enfermedades infecciosas y microbiologia clinica Pub Date : 2024-06-01 DOI:10.1016/j.eimc.2023.04.002
Enrique Contreras-Macías , María de las Aguas Robustillo-Cortés , Ramón Morillo-Verdugo
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Abstract

Objectives

The patient living with HIV (PLWH) profile has changed and with it, the importance of patient-oriented pharmaceutical care (PC) has been highlighted, for which the stratification tool of the Capacity-Motivation-Opportunity (CMO) PC model helps us which adapts to the needs of each patient. To assess the true relevance, our main objective is to evaluate the differences of one-year mortality among PLWH stratified according to this model.

Methods

A single-center observational analytical survival research study including adult PLWH on antiretroviral therapy (ART) from January-2021 to January-2022 treated at hospital pharmacy outpatient service according to CMO pharmaceutical care model.

Results

A total of 428 patients were included, a median age of 51 years (interquartile range 42–57 year). Overall, the number of patients stratified according to the CMO PC model was 86.2% at level 3, 9.8% at level 2, and 4.0% at level 1. Cox proportional hazard model that included the stratification level was associated with a higher mortality, whose level 1 patients had a 99.7% higher mortality (Hazard ratio = 0.0003; 95%CI: 0.001–0.027).

Conclusions

To sum up, mortality of-one year differs when comparing the PC strata of level 1 and non-level 1, although being similar in age and other clinical conditions. This result suggests that the multidimensional stratification tool, included in the CMO PC model, could be used to modulate the patients intensity follow-up and design interventions more tailored to their needs.

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根据药物护理模式的分层水平,HIV感染者一年死亡率的相关因素。
目的艾滋病病毒感染者(PLWH)的情况发生了变化,以患者为导向的药物治疗(PC)的重要性也随之凸显,能力-动机-机会(CMO)PC 模型的分层工具可以帮助我们适应每位患者的需求。为了评估其真正的相关性,我们的主要目标是评估根据该模型进行分层的 PLWH 一年死亡率的差异。结果 共纳入 428 名患者,中位年龄为 51 岁(四分位距为 42-57 岁)。总体而言,根据 CMO PC 模型进行分层的患者中,86.2% 的患者处于 3 级,9.8% 的患者处于 2 级,4.0% 的患者处于 1 级。结论综上所述,尽管年龄和其他临床条件相似,但将 PC 分层 1 级和非 PC 分层 1 级的患者进行比较,其一年的死亡率是不同的。这一结果表明,CMO PC 模型中包含的多维分层工具可用于调整患者的随访强度,并设计出更符合患者需求的干预措施。
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来源期刊
CiteScore
2.10
自引率
8.00%
发文量
194
审稿时长
29 days
期刊介绍: Hoy está universalmente reconocida la renovada y creciente importancia de la patología infecciosa: aparición de nuevos agentes patógenos, de cepas resistentes, de procesos con expresión clínica hasta ahora desconocida, de cuadros de una gran complejidad. Paralelamente, la Microbiología y la Infectología Clínicas han experimentado un gran desarrollo como respuesta al reto planteado por la actual patología infecciosa. Enfermedades Infecciosas y Microbiología Clínica es la Publicación Oficial de la Sociedad Española SEIMC. Cumple con la garantía científica de esta Sociedad, la doble función de difundir trabajos de investigación, tanto clínicos como microbiológicos, referidos a la patología infecciosa, y contribuye a la formación continuada de los interesados en aquella patología mediante artículos orientados a ese fin y elaborados por autores de la mayor calificación invitados por la revista.
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