Medication Therapy Management Services for HIV-Positive Patients on Antiretroviral Therapy in Adamawa State, North East Nigeria

Medication therapy management services offer structured frameworks for pharmacists to comprehensively review drug therapy, identify drug-related problems, and improve patient outcomes in complex chronic disease populations. HIV-positive patients on antiretroviral therapy represent a population with substantial drug therapy complexity due to polypharmacy, co-infections, and strict adherence requirements. This study evaluated the implementation and outcomes of a structured medication therapy management program for antiretroviral therapy patients at an antiretroviral therapy clinic in Adamawa State, North East Nigeria. A pre-post interventional design was used with 120 patients enrolled over eight months. The program included comprehensive medication reviews, identification and resolution of drug-related problems, patient education, and adherence support. Pharmacists identified a mean of 3.1 drug-related problems per patient, most commonly related to adherence barriers, drug interactions with herbal products, and suboptimal dosing in patients with renal impairment. Post-intervention, overall adherence improved from 44 percent to 72 percent, and mean CD4 count increased significantly. The proportion of patients achieving viral suppression rose from 51 percent to 74 percent. Drug-related problem resolution rate was 83 percent. These results provide compelling evidence for integrating medication therapy management into routine antiretroviral therapy care in the North East zone. Training of pharmacists in HIV-specific medication therapy management and formal integration into antiretroviral therapy program protocols are recommended. Keywords: medication therapy management, HIV, antiretroviral therapy, Adamawa State, drug-related problems