PHARMACISTS PROVISION OF CONTINUITY OF CARE TO PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

A pharmacy program for providing continuity of care to patients infect ed with the human immunodeficiency virus (HIV) is described. The progr am was implemented at three practice sites in Toronto: a tertiary care teaching hospital; an outpatient community pharmacy that is part of t he hospital; and an ambulatory care clinic affiliated with the hospita l. An HIV pharmacy practice was established at the hospital in 1993. T he community pharmacy serves at least 30% df the HIV-infected patients in Ontario who are receiving antiretrovirals; patient counseling is e mphasized. The ambulatory care clinic's HIV program was established in 1994; the pharmacist sees patients at the clinic or in their homes. T o address the need for greater continuity of care, the following issue s were addressed: workload involved in providing pharmaceutical care t o HIV-infected patients, establishing patient pharmacy profiles common to the three sites, streamlining communication among the sites, creat ing a process for identifying patient problems in the community settin g, collaborating on research and projects, and forging links with othe r pharmacists caring for HIV-infected patients. The program has enhanc ed the ability of pharmacists to make informed recommendations and car e plans, increased patient follow-up, improved cross-coverage of patie nts in the absence of an HIV pharmacist, increased sharing of drug inf ormation, and led to joint collaboration on projects. A pharmacy progr am to serve HIV-infected patients was implemented at three sites and s uccessfully integrated under a continuity-of care model.