CHAPTER ONE

INTRODUCTION TO THE STUDY

1.1     Background to the Study

The practice of HIV care has dramatically changed during the past two decades. Knowledge regarding HIV pathophysiology has quickly accumulated and has led to the development of new medications. In addition to knowledge updates, the attitudes of health care professionals toward current concepts about HIV care are even more critical. The core philosophy of modern HIV care puts emphasis on patient autonomy and optimal utilization of health care professionals’ different specialties. Research evidence derived from clinical, economic, and humanistic outcomes also strongly supports the importance of patient autonomy and a team approach to HIV care. Pharmacists’ knowledge and attitudes toward HIV can significantly influence patient outcomes (Hsiang-Yin, 2014).

Given the prevailing concept of a team approach toward HIV care, only when all health care providers share the same high level of knowledge and positive attitudes could the quality of patient care be ensured (Hsiang-Yin, 2014). Pharmacists are highly accessible to chronically ill patients such as those with HIV, especially when the disease becomes controlled and the patient only needs to visit a pharmacy to have their prescription refilled (Hsiang-Yin, 2014). Pharmaceutical care has significantly reduced the occurrence of drug-related problems and fulfilled the desired outcomes of drug therapy in other diseases and conditions such as anticoagulation, hyperlipidemia, and asthma (Jungnickel PW, 1997). Studies have also shown that pharmacists’ participation in the management of poorly controlled HIV patients resulted in better outcomes (Jungnickel PW, 1997).

This study is focused on the attitude and knowledge of community pharmacists on HIV infected which also received special mention in the WHO adherence report (WHO, 2013). HIV infected is a disease of pandemic proportions increasingly making its presence felt in the developing world where, it is predicted; most of the world’s HIV burden will in future be borne (King H, 1998). Furthermore, it is a disease where antiretroviral therapy and lifestyle modification play major roles in the treatment and management of the condition, (Chitre MM, 2016) and where health promoting interventions in both these therapeutic areas are accommodated within the pharmacist’s defined scope of practice (Wermeille J, 2014) (Kiel PJ, 2015) (Johnson LC, 1997).

Most, if not all, HIV patients make use of long-term antiretroviral therapy to manage their disease. The prescription refill dynamic provides for frequent personal and informed contact between the patient and the pharmacist and thus positions the community pharmacist for roles in HIV care beyond the traditional medicine dispensing role (Kiel PJ, 2015) (Johnson LC, 1997). Encounters of this nature present pharmacists with ideal opportunities to provide pharmaceutical care across a range of chronic diseases.