Long-acting injectable antiretroviral treatment can improve medication adherence in patients who struggle with regularly taking daily pills, according to research presented at the Association of Nurses in AIDS Care 2023 Annual Meeting.
New data from an intervention program at Cooper University in Camden, New Jersey, suggest the treatment is well-tolerated across individuals of all ages and genders.
Although the program has an 84% viral load suppression, it also has patients that suffer the challenges associated with taking oral medications, note co-authors Elizabeth Munoz, BSN, and Elizabeth Fletcher, DNP, APN-BC, AAHIVS, both from Cooper University Health Care.
These challenges can lead to poor adherence, increased viral loads, and drug resistance, they explain. In some cases, patients hide the fact that they are taking medication from others, which can lead to inconsistent timing of ingestion. Others forget to take their medication altogether or have difficulty swallowing pills.
In 2020, the US Food and Drug Administration approved long-acting cabotegravir with rilpivirine (Cabenuva) that provided a solution to this issue. Rather than taking pills every day, patients could be given injections on a monthly or bi-monthly basis in an office appointment.
By December 2021, long-acting cabotegravir with rilpivirine was approved for preexposure prophylaxis (PrEP), extending this option to a new population of patients.
A total of 52 individuals with HIV in the program at Cooper switched from oral to long-acting medication regimens. An additional 16 individuals on PrEP also switched injections or started on one for the first time.
Most patients (60.3%) were between 31 and 50 years of age, 20.5% were 18-30, and 19.5% were over age 50. The group included 51 males, 15 females, and two transgender individuals.
All patients reported being satisfied with the injection that eliminated the need for daily oral medications. Only one patient switched back to oral medication due to discomfort from the injections, the authors report.
In the study cohort, all individuals with HIV remain undetectable and all individuals taking PrEP remain HIV negative.
The results suggest that “long-acting injections are well tolerated and lead to improved adherence in patients facing challenges with oral medications,” the authors presented.
They said that a care team is necessary to build an effective injection program. “Success requires a dedicated RN for administration of long-acting injections, pharmacy liaison for prior authorization reordering medication, and a navigator for tracking and ensuring patient follow-up,” they added.
Association of Nurses in AIDS Care 2023 Annual Meeting. October 25-28, 2023.
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