OC In+Care: Newsletter for providers serving people living with HIV/AIDS in Orange County Orange County In+Care Goals: Increase the proportion of newly diagnosed individuals linked to clinical care within three months of diagnosis. Increase the proportion of PLWH who are in continuous care. Increase the proportion of PLWH with suppressed viral loads (less than 200 copies per mL). Barriers to Treatment Adherence Although a patient's ability to commit to a treatment plan should be assessed prior to initiating treatment, unexpected changes in the patient's life can disrupt treatment adherence. There may be many barriers that prevent a patient from adhering to their treatment regimen. Some barriers that may arise are: * Active substance abuse (drugs and/or alcohol) * Patient feels healthy * Food requirement * Forgot or busy * Away from home * Traveling * Change in daily routine * Side effects * Depression or illness * Lack of interest * Desire to have a drug "holiday" * Treatment fatigue Strategies to Treatment Adherence It is important for the medical provider to understand and be aware of the patient's overall situation. During the appointment, ask the patient if there are any changes in their lifestyle or daily routine that may affect their medication intake. Education should include potential consequences of not adhering strictly to the treatment plan. Let them know that changes in lifestyle may disrupt their treatment plan and remind them of their treatment regimen. Emphasize the importance of committing to the plan even with these changes. A common reason for why many patients discontinue their treatment regimen is because they do not feel sick. Encourage patients to continue their medication even when they are physically feeling well. Communication between the doctor, case manager, and pharmacist (with appropriate release of information) is key to helping them continue to commit to their treatment plan. Some patients may find using a diary or medication log useful in remembering what medications to take and when to take them. The patient can include individuals to support them in their treatment plan. This can be a family member, peer, or friend whom they feel comfortable with and have disclosed their HIV/AIDS status. The Pharmacist's Role The pharmacist's role in HIV care is essential. A patient may see multiple providers with prescribing privileges, but typically goes to one pharmacy. Because of this, their pharmacy becomes the "hub" for the patient's care. As noted before, it is important for doctors, pharmacists, and case managers (if applicable) to have a good relationship. Doctors should contact the pharmacy to follow up on a patient's treatment plan and more importantly, learn of any other drugs the patient is taking that may lead to drug-drug interactions. Pharmacists should contact the doctor if a patient's treatment plan may lead to adverse effects. Contacting the doctor or case manager may also be necessary if patients are not picking up their medications (non-adherence). Orange County Resources Check out HIV THRIVE ( hivthrive.com ), for information on living with HIV/AIDS and improving overall wellness. Peer Support Services (PSS) offers support to individuals who are living with HIV/AIDS. For more information on PSS, contact Bobby Avalos at (714) 868-1829 or e-mail firstname.lastname@example.org Click here to the view the full OC In+Care newsletter. OC In+Care is a project of the Orange County HIV Quality Management Committee. The HIV Quality Management Committee works to increase the quality of Ryan White services. For more information about the committee, please call (714) 834-8711. Click here to subscribe to the OC In+Care newsletter. If you have feedback or topic suggestions for future newsletters, please contact Melissa Corral at MCorral@ochca.com .