Improving Medication Adherence to Reduce New HIV Infection Cases In Broward County Florida

Transcription

1 Improving Medication Adherence to Reduce New HIV Infection Cases In Broward County Florida Team Organizational Development Roland J. Martinez, BPA, ASQ CMQ/OE, CSSGB, Director of Organizational Development Caroline Bartha, CSSMBB, MBA/MPA, PHFM, Director of Performance Excellence Eduardo Safille, J.D., Human Resources Director Juan M. Morejon, BHSA, CSSGB, Data & Statistics Manager

2 Infection Cases In Broward County Florida Background In October 2014, the Florida Department of Health in Broward County HIV medication pickup rate was 68%. Antiretroviral therapy (ART) has proven extremely effective in the treatment of HIV and AIDS. The ability to effectively combat the disease is ineffective when individuals do not take their medication as prescribed and do not attend their scheduled medical appointments. Non-adherence to effective ART and medical visits is widespread in the United States, especially among ethnic minorities.

3 Infection Cases In Broward County Florida Project According to the CDC in 2013, Florida had the highest level of HIV infection in the U.S. Broward has the 2nd largest new HIV infection rate and 4th largest AIDS case rate in the nation. Broward has approximately 9% of Florida's population and 17% of persons living with HIV/AIDS. There are over 19,500 people living with HIV/AIDS in the County and the rate continues to increase. Medication adherence reduces viral load levels, making individuals less likely to transmit the HIV virus and improving health outcomes.

4 Infection Cases In Broward County Florida Project In October 2014, 68% of people living with HIV/AIDS in Broward picked up their anti-retrovirals every 30 days. Issue: Without a dedicated intervention to improve medication pick-up rates, HIV rates may continue to increase in Broward County.

5 Infection Cases In Broward County Florida Process The Florida Department of Health in Broward County benchmarked against community partners and adopted several solutions based on community needs. Solutions include: implementation of a medication reminder recall system, a prescription auto fill and call program, assignment of non compliant clients to HIV disease intervention specialists, gaining access to accurate medication pick-up data from the state program office, and establishing relationships with pharmacies to obtain accurate pick-up data.

6 Improving Medication Adherence to Reduce New HIV Infection Cases In Broward County Florida As of October 2015 medication pick-up rate has increased adherence to 86% from 68% in The auto fill/call system in the pharmacy has made a significant impact in customer service and has increased adherence. The automated system makes 3,000 client contact phone calls per month with a call success rate approaching 90%.

7 Infection Cases In Broward County Florida Outcomes The HIV viral load suppression rate and new infection rate will continue to be tracked, as these are lagging indicators. DOH-Broward is optimistic that this will improve over the long term and achieve the CDC Winnable Battle of "Reducing New HIV Infection", "National HIV/AIDS Strategy" and the targets of the "Fast- Track Cities" initiatives.

8 Infection Cases In Broward County Florida Project Summary Project Goals Improve medication Pick-up Rates Reduce Community Viral Load Reduce New Cases of HIV infections Process Improvements: Implement medication reminder recall system. Initiate Rx auto fill/auto call program. Link non compliant clients to HIV DIS. Relationship & Gain access to accurate data from state program office. Understanding of how data is calculated by state program office. Project Outcomes The HIV Medication pickup rate increased from 68% in October 2014 to 86% in October New HIV Infection rate data lags 10 months. Medication pickup rates will correlate to decrease viral load and decrease CD4 count. Leadership Learning Measurement and Analysis of Client Data New Software System To Access Real Time Data Develop Relationships Negotiations Consensus

9 Improving Medication Adherence to Reduce New HIV Infection Cases In Broward County Florida Team Organizational Development