13th Annual Conference of the British HIV Association 29 March–1 April 2007, Brighton, UK

IS HOME DELIVERY (HD) OF HAART SAFE? A CASE CONTROL STUDY

HIV Med 2007; 8(Suppl. 1):6 (abstract no. O22)

Matthew Hamill¹, Derval Harte¹, Vicky Jones², Andrew Copas², Erica Allason-Jones¹, Ian Williams², Rob Miller² and Simon Edwards^1
1Department of Genito Urinary Medicine, Camden Primary Care Trust, Mortimer Market Centre, London, UK, ²Centre for Sexual Health and HIV Research, University College, London, UK

AIM: Service capacity and financial constraints have the potential to adversely affect delivery of care. There is a need for service developments, which maintain standards of care with improved convenience to patients and at a lower cost. HD of HAART medication has the potential to both improve patient convenience and be more cost effective, but may impact on the monitoring of safety and efficacy parameters. The aim of this study was to investigate the clinical, virological and safety outcomes in patients using a HD service.

METHODS: Case–control analysis of patients stable on effective HAART (VL <50 copies/mL) attending a large HIV outpatient clinic between 10/04 and 01/07. Cases (HD): patients receiving ART medication through HD, Controls: patients receiving ART through clinic pharmacy. Outcome measures: incidence of virological failure, therapy related adverse events and frequency of clinic attendance.

RESULTS: Preliminary analysis: HD: n=434, male 86%, mean age 40.9 years. Controls: n=1211, male 83%, mean age 41.5 years. The incidence of virological failure (confirmed >400 copies/mL) was significantly lower in HD versus controls: 3% versus 7%, P<0.004. Emergency and routine attendance at the clinic was also lower in the HD group.

DISCUSSION: HD of ARV medication was associated with a lower rate of virological failure and frequency of clinic on-call attendance in patients stable on effective HAART compared with those using the clinic pharmacy. Results on the rate of therapy related adverse events and the impact of selection bias, as a confounder, will be presented. Preliminary data supports HD as an acceptable service model.

2007-03-29
O22

Copyright © 2007 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD