International Journal of STD & AIDS > Volume 19, Number 8 > Pp. 533-535

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Original research articles

Evaluation of a home-delivery service for HIV-infected patients attending an inner London HIV treatment centre

D Harte MRCPI ^*, M Hamill MRCP ^*, S G Edwards FRCP ^*, A J Copas PhD , J Minton BPharm , V L Jones BSc , E Allason-Jones FRCP ^*, I G Williams FRCP  and R F Miller FRCP  

^* The Mortimer Market Centre, Department of Genitourinary Medicine, Camden PCT, London; Centre for Sexual Health and HIV Research, Department of Population Sciences and Primary Care, University College London, The Mortimer Market Centre, London WC1E 6JB; Pharmacy Services, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK

Correspondence to: Professor R F Miller Email: rmiller{at}gum.ucl.ac.uk

Home delivery (HD) of medication is a goal of the Department of Health’s Pharmacy in the Future; Implementing the NHS Plan. We evaluated the safety and effectiveness of an HD service for antiretroviral therapy (ART). Patients on ART with stable viral load (VL) <50 were identified. Comparison was made between patients using HD and those using the clinic-based pharmacy (CP). The primary endpoint was HIV virological failure (VF) (HIV VL >400 copies/mL on two consecutive occasions). Secondary endpoints included frequency of outpatient attendances (OPA) and an incidence of adverse events. Cumulative incidences (CulmIn) for each outcome event were calculated. Incidence-rate ratios (IRR) were obtained using Poisson regression. Of 1663 patients identified; 450 received HD and 1213 used CP. CuImIn of VF was =4% in those using HD and =7% in those using CP (IRR [95% confidence intervals, CI] =0.53, 0.32–0.90). HD patients had fewer OPA, less frequent blood test monitoring and less frequent abnormal liver function results (IRR [95% CI]= 0.63 [0.59–0.67] and 0.59 [0.53–0.67], 0.68 [0.65–0.71] and 0.64 [0.53–0.78], respectively). Patients deemed stable enough on social, psychological and medical grounds to receive HD of ART had a lower risk of VF, fewer OPA and no increase in adverse events when compared with patients using CP.

Key Words: patient choice • antiretroviral therapy • home delivery • HIV

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