Approximately 90% of socially vulnerable patients with HIV did not fill their prescriptions for ART within 7 days of being discharged from a specialty hospital in Canada, according to research published in Open Forum Infectious Diseases.
“Attainment of the UNAIDS 90:90:90 targets is predicated on successful linkage to and retention in care,” the researchers wrote. “The transition from hospital to community can potentially disrupt retention in care, particularly in complex patients. Interventions facilitating post-hospital discharge continuity of care are therefore required to optimize the health of the most complex and marginalized individuals with HIV.”
The researchers conducted a retrospective study of patients admitted to Casey House — a 14-bed community-based hospital in Toronto, Canada — between April 1, 2009, and March 31, 2015. The hospital’s discharge plan includes providing prescriptions for ART and a follow-up appointment with a family physician or HIV specialist within 7 days of discharge. The researchers chose a 7-day follow-up as the primary outcome because patients who did not fill prescriptions within the 7-day period risked treatment interruption.
The researchers found that only 22 patients out of 206 “socially marginalized individuals living with HIV and multiple comorbid conditions” (10.7%) filled a prescription for ART within 7 days of being discharged from the hospital. Fifty-three (25.7%) and 31 patients (15%) filled a prescription for an antidepressant or antipsychotic, respectively.
The researchers wrote that overall, 143 patients (69.4%) filled any prescription in the 7 days following discharge, and most were for anti-infective therapy, symptom management, pain control and treatment of comorbid mental health issues.
The researchers concluded that “linkage to outpatient care was suboptimal. Additional research is required to elucidate barriers to accessing ART following discharge and support continuity of care in the community to support attainment of 90:90:90 targets for this especially vulnerable population of persons with HIV.” – by Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.