Simplification and Multidimensional Adaptation of the Stratification Tool for Pharmaceutical Care in People Living With HIV
Ramón Morillo‐Verdugo, Tamara Aguilar Pérez, Mercedes Gimeno-Gracia, Carmen Rodríguez, María de las Aguas Robustillo Cortés, María de las Aguas Robustillo Cortés, Aitziber Illaro Uranga, Alicia Lázaro López, Angels Andreu Crespo, Aránzazu Linares Alarcón, B Proy Vega, B. García, Carlos Seguí Solanes, C Rodríguez-González, Carolina Aguilar Guisado, Elena Cárdaba García, Emilio Cuadrado, Emilio Monte‐Boquet, E Abad Lecha, Esther Vicente Escrig, Gabriel Mercadal-Orfila, Herminia Navarro Aznárez, Inmaculada López, I Cañamares Orbis, Jara Gallardo Anciano, Javier Casas Arrate, Javier Sánchez-Rubio Ferrández, Joaquín Ignacio Serrano López, José Alberto Peña Pedrosa, Jose Sebastián Roldan González, Luis Carlos Fernández Lisón, Luis Margusino Framiñán, Luis Ortega Valín, Maite Martín, Manuel Vélez, María Ángeles Andreu Crespo, Maria Carmen Rosado Maria, M García Coronel, María José Huertas Fernández, Mercedes Gimeno-Gracia, Mercedes Manzano García, Noelia Garrido Peña, O Mora Atorrasagasti, P Sanmartín Fenollera, Pilar Díaz Ruiz, Ramón San Miguel Elcano, Raquel Fresquet Molina, Vera Áreas del Aguila, Dr Elena Rebollo-Gómez, Dr Vanessa Marfil
Abstract
BACKGROUND: People living with human immunodeficiency virus (HIV) require specific pharmaceutical care (PC). Although the 2017 Capacity-Motivation-Opportunity (CMO) PC model allows a multidisciplinary approach that focuses on patient needs, it is too complex and presents room for improvement. OBJECTIVE: The aim of this study is to simplify and adapt the previous 2017 PC tool through a multidimensional approach to improve HIV patient care, to prove the validity of the model in real-life patients. METHODS: The new PC tool was generated by keeping some of the variables of the 2017 document and conducting a literature search. Content validity was determined by a 2-round Delphi methodology with an expert panel of 42 pharmacists. Consensus for the first and second rounds was defined as ≥70% agreement. The tool generated was validated in 407 real-life patients. RESULTS: Thirty-seven experts completed the first round of the Delphi survey and 36 the second. No consensus was reached for 3 variables, any of the frequency options and 4 interventions, while the experts agreed not to include 1 intervention in round 1. Consensus to include them was found for all but 1 variable and 1 intervention in round 2. The final tool obtained to select and stratify HIV-positive patients was composed of 9 dimensions divided into 17 variables. The new tool was validated with real-life patients and 3 priority levels were defined. CONCLUSIONS AND RELEVANCE: We created a new pyramid of score thresholds to classify patients into priority levels. The new tool simplifies the 2017 model and improves its utility to help HIV-positive patients, owing to its multidimensional approach.