Pharmacists' provision of continuity of care to patients with human immunodeficiency virus infection

A pharmacy program for providing continuity of care to patients infected with the human immunodeficiency virus (HIV) is described. The program was implemented at three practice sites in Toronto: a tertiary care teaching hospital; an outpatient community pharmacy that is part of the hospital; and an ambulatory care clinic affiliated with the hospital. An HIV pharmacy practice was established at the hospital in 1993. The community pharmacy serves at least 30% df the HIV-infected patients in Ontario who are receiving antiretrovirals; patient counseling is emphasized. The ambulatory care clinic's HIV program was established in 1994; the pharmacist sees patients at the clinic or in their homes. To address the need for greater continuity of care, the following issues were addressed: workload involved in providing pharmaceutical care to HIV-infected patients, establishing patient pharmacy profiles common to the three sites, streamlining communication among the sites, creating a process for identifying patient problems in the community setting, collaborating on research and projects, and forging links with other pharmacists caring for HIV-infected patients. The program has enhanced the ability of pharmacists to make informed recommendations and care plans, increased patient follow-up, improved cross-coverage of patients in the absence of an HIV pharmacist, increased sharing of drug information, and led to joint collaboration on projects. A pharmacy program to serve HIV-infected patients was implemented at three sites and successfully integrated under a continuity-of care model.