Abstract
Introduction: Human Immunodeficiency Virus (HIV) affects approximately 39.9 million people worldwide, according to the latest 2024 UNAIDS report (1). In Brazil, data from the Notifiable Diseases Information System (SINAN) indicate that, between 2007 and 2023, the disease affected 489,594 people (2). Furthermore, between 2011 and 2021, 12,686 positive diagnoses were recorded among individuals aged 60 years or older (3). Factors such as comorbidities, polypharmacy, drug interactions, and physiological changes make older adults a vulnerable group, with a higher risk of adverse reactions and medication interactions, in addition to facing other challenges related to pharmacotherapy (4). Therefore, they are eligible for Clinical Pharmaceutical Services, and the pharmacist’s role can be decisive. Objective: To evaluate the impact of clinical pharmaceutical services on health outcomes in older patients living with HIV. Methods: This systematic review was conducted following the PRISMA guidelines. The literature search was performed in September 2024 using the PubMed/Medline, Scopus, Web of Science, EMBASE, and LILACS databases. Standardized and nonstandardized terms related to “pharmaceutical services,” “HIV,” and “older adults” were used. Studies were independently analyzed by two researchers, and disagreements were resolved by consensus. Extracted data included author, year of publication, participants, main results, humanistic, economic, and clinical outcomes, as well as the pharmaceutical service provided. Results: A total of 1,647 studies were identified for screening, of which 6 were included in the analysis. The most evaluated clinical pharmaceutical service was pharmacotherapeutic followup, present in all studies. The most frequently used outcomes to assess clinical pharmaceutical services were clinical outcomes, including treatment adherence, cell counts, toxicity risk, reduction in the number of prescribed medications, mortality, and increased life expectancy. All studies showed improvements in outcomes associated with pharmaceutical interventions, highlighting pharmacotherapeutic followup as the most effective service for improving these results. Conclusion: Clinical pharmaceutical services have a positive impact on clinical, humanistic, and economic outcomes in older patients living with HIV. However, there is a gap in the literature regarding economic and humanistic outcomes, reflecting insufficient attention to patients’ quality of life and wellbeing. This lack of approaches contributes to the stigma faced by this population, which may lead to social isolation and treatment discontinuation.
