Seattle Post-Intelligencer examines efforts to improve medication management for HIV-positive people

The Seattle Post-Intelligencer on Monday examined efforts by some organizations and pharmacies in the city and surrounding area to improve medication management for HIV-positive people.

The "dozens of pills or more" that some people living with HIV need to take daily "can seem overwhelming," the Post-Intelligencer reports, "Add homelessness, mental illness or drug addiction into the mix, and taking much-needed medication falls from the top of the priority list."

Nurses at the Bailey-Boushay House spend about 56 hours weekly separating two million pills into box sets for each of their clients. The program is operated by Virginia Mason Medical Center and serves about 200 HIV/AIDS patients through its adult day program. More than two-thirds of the clients have chemical dependencies or mental illnesses and almost one-third are homeless. Program staff use "medisets" -- long plastic strips of pills that can be individualized for patients and doses. The program does not require clients to be drug-free or sober to receive treatment, according to the Post-Intelligencer. "We don't know to what extent ongoing drug use interferes or affects the medication they take, but crack or heroin interferes with adherence," Sandy Eastwood, an HIV/AIDS-certified nurse at Bailey-Boushay, said, adding, "They're more than just an HIV-infected person or a person using crack every day, or a homeless person. These are problems no one can manage by themselves -- these folks have struggled their whole lives."

MOMS Pharmacy in Seattle provides HIV-positive people with the option of receiving its version of individualized medications in sealed packs with time-stamping information. The pharmacy also offers prefilled medicine trays, as well as specialized services such as insurance advice, counseling, educational sessions, refill reminder programs and delivery service options. In addition, Rosehedge AIDS Housing and Health Care provides weekly medication boxes for its clients. According to Jayme Sanford, interim director of clinical services at Rosehedge, such facilities see a skewed segment of the HIV-positive population. "On paper, they look good, but HIV dementia and other problems have set in, and even though newer medication has people living longer lives, most of our residents probably won't ever go and live on their own," Sanford said (Black, Seattle Post-Intelligencer, 8/11).