The more complex a disease and its treatment are to manage, the greater the need for patient support to improve self-care, symptom management, and, ultimately, adherence. Under the traditional specialty pharmacy model, patients receive some drug education, side effect management, and other adherence support. CVS Health’s HIV Care Management builds significantly on that model by adding more frequent, proactive, and personalized interactions to help improve member engagement. By looking at the whole patient, our care management nurses, in consultation with pharmacists when needed, address a wide range of issues including:
- Medication optimization, which addresses adherence challenges, such as side effects, across all prescriptions, as well as safety monitoring, including potential drug interactions. Nurses review a patient’s risk factors to help ensure the patient is on the optimal treatments according to national guidelines.
- Care optimization, including advice on cost issues and transportation concerns. Nurses can engage resource specialists and social workers for assistance, when needed.
- Management of symptoms, which can include weight loss, diarrhea, skin conditions, and medication side effects.
- Self-care education regarding risk behaviors, transmission, appropriate screenings, lab monitoring and results, vaccinations, nutrition, and smoking cessation.
- Comorbidity management, including screening for other sexually transmitted diseases, cancer, osteoporosis, diabetes, viral hepatitis, as well as depression and anxiety, which can hinder care.
- Continuity of care, which means the nurse collaborates with other providers and supports consistent, healthy patient-provider relationships.
- Emotional and social support, which includes helping patients navigate concerns about social stigma, which can be a deterrent to adherence.