目的： 高效能抗愛滋病毒治療 (highly active antiretroviral therapy, HAART) 是否能有效控制血漿病毒量、提高CD4 淋巴球數，降低伺機性感染、腫瘤及死亡風險，取決於病人服藥順服性。本研究主要在評估藥師進行藥事照護，對於愛滋病感染者服藥順服性、疾病控制以及藥品相關知識正確性的影響。

方法： 第一階段在2010 ~ 2011 年納入門診所有HAART 個案，每三個月衛教一次病人，為期半年，藥師介入前後利用問卷評估藥品使用知識正確性、藥品持有率 (medication possession ratio, MPR) 及CD4 淋巴球數值的差異，並記錄期間藥品相關副作用及交互作用。第二階段在2012 ~ 2013 年納入相同條件個案，每次回診時透過藥師衛教評估半年後CD4 淋巴球數值及血漿病毒量的變化，並紀錄期間藥品相關副作用。

結果： 第一階段29 位個案在藥師介入前後半年，藥品持有率顯著改善 (0.962 ± 0.067 vs. 0.997 ± 0.010, p =0.04)、藥品使用知識正確性得分在藥師介入後3 ~ 6 個月也有顯著提升。第二階段62 位個案在介入後半年，CD4 淋巴球數值 (353.81 ± 176.15 vs. 489.97 ± 186.04 cells/mm3, p = 0.002) 及血漿病毒量低於40copies/mL 的人數皆顯著增加。
結論： 透過藥師介入定期追蹤衛教有利於增加病人服藥順服性及持續並有效地控制疾病。
 

Purpose: The effectiveness of treating human immunodeficiency virus (HIV) is mainly determined by patients’ adherence to highly active antiretroviral therapy (HAART). uboptimal adherence can lead to virological failure, opportunistic infection, drug resistance, and even death. The aim of this study is to evaluate the effect of pharmacists’ intervention on the correlation of HIVinfected patients’ medication adherence, knowledge about medication regimen, and clinical outcome.

Methods: During the first phase, pharmacists provided intervention to all patients who are receiving HARRT from the outpatient infectious disease clinic every 3 months, and the total duration was 6 months. The patients were included from 2010 to 2011. The patient knowledge was measured by quesionaires, and other outcomes include medication possession ratio (MPR), improvement in CD4 count, side effects and drug interactions. Phase two was conducted from 2012 to 2013. The inclusion criteria was the same as phase one study. The outcomes measured were improvement in CD4 count and viral load. Any drug-related side effects were also recorded.

Results: In phase one, pharmacist provided intervention to 29 HIV patients for six months. Compared to baseline, MPR and patients’ knowledge scores improved significantly after receiving pharmacist intervention. 62 patients received pharmacist intervention in phase two. There was significant improvement in patients’ clinical outcome: CD4 count and patients with viral load less than 40 copies/mL.
Conclusion: This study demonstrated that pharmacist intervention improved patient adherence to medication, knowledge of medication regimen, and clinical outcome. The occurrence of adverse effects also decreased.