Therapeutic drug dilemma and pharmaceutical mediation in HIV-positive children in Nigeria University Teaching Hospital

Abstract

Background: In spite of advances in the use of combined antiretroviral drugs in the management of human immunodeficiency virus (HIV) infection, drug therapy problems (DTPs) cause hindrance in the developing countries including Nigeria.

Objective: The present study assessed DTPs and pharmacists’ intervention impact among HIV-positive children on combined antiretroviral therapy (cART) in the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria. Eighty HIV-positive children on cART, attending Institute of Human Virology, Nigeria (IHVN) Clinic of UITH, and refilled their prescriptions based on Paediatric Pharmacy Order Form (PPF), were enrolled into the study.

Methodology: The DTPs encountered among those children were collected through personal interaction with the children/caregivers, patients’ medical folders and PPF. The DTPs observed at baselines were tailed using pharmaceutical interventions at 2 and 4 months.

Result: The children studied were mostly males (60.0 %) with a median age of 3.16±0.74 years. Zidovudine backbone regimen was frequently prescribed first-line cART. At baseline, 39.0% of the children had DTPs with an average number of 2.3±4.7 per child. Of the 39.0% DTPs encountered, 6.4% were directly related to PPF. Dosage too low (1.3%), dose not indicated (1.3%), ineffective drugs (1.3%), inappropriate drug adherence (21.3%), adverse drug reactions (10.0%) and dosage too high (3.8%) were the DTPs observed at baseline 0-month. In the last 4^th month after pharmacists’ intervention, all DTPs were completely resolved among the children including those related to PPF.

Conclusion: The pharmacist’s mediation in the management of DTPs significantly improved health of the HIV-positive children in this hospital.