Implementing Semi-Automated Medication Dispensing for People with HIV: A Community-Based Alternative to Traditional...

Area of Science:

• Pharmaceutical care
• HIV/AIDS management
• Health informatics

Background:

• Maintaining adherence and access to antiretroviral treatment is crucial for people with HIV (PWH).
• There is a need to shift from drug-centered to patient-centered care models.
• Integrating care interventions into community settings can improve patient outcomes.

Purpose of the Study:

• To implement and evaluate an outpatient hospital pharmaceutical care model for PWH.
• To utilize a proprietary app and automated locker systems for medication delivery.
• To integrate care within a community setting (BCN-Checkpoint).

Main Methods:

• A pre-implementation phase defined critical steps including team roles, app adaptation, patient journey mapping, system integration, staff training, data protection review, and simulations.
• A two-phase simulation (fictitious and real users) validated the system.
• An initial pilot study included 46 patients.

Main Results:

• High system uptake and adherence to the dispensing pathway were observed.
• Few discontinuations occurred due to personal preferences or alternative options.
• Implementation barriers included technical, process, operational, coordination, and user-related challenges.
• A communitarian setting, flexible protocols, and intersectoral collaboration positively impacted retention and satisfaction.

Conclusions:

• An outpatient hospital medication dispensing model using an app and automated lockers is feasible for PWH.
• Successful implementation requires meticulous attention to procedures, timely adaptations, and comprehensive staff training.
• This model supports patient-centered care and enhances satisfaction.