Medical resident knowledge and comfort regarding HIV antiretroviral drug interactions

Abstract

Bevin Hearn, Grace Huang,Jennifer Allen, Wendy Stead

Many residency programs lack dedicated HIV curricula and residents report discomfort caring for these patients. Antiretroviral medication interactions are particularly relevant as adverse events frequently occur. This study evaluated the impact of a didactic session regarding antiretroviral drug interactions on resident knowledge and comfort. We conducted a prospective cluster-randomized controlled trial of internal medicine residents at an urban academic medical center. The intervention was a case-based lecture explaining the pharmacologic mechanisms behind drug-drug interactions with HIV antiretrovirals. The control group did not receive this intervention. We assessed knowledge and comfort in all subjects before and two months after the intervention. We enrolled 74 residents (76% of those surveyed). Baseline knowledge scores did not differ between groups, and delayed post-test scores showed improvement in the intervention group compared with controls at a level approaching significance (p=0.1). Analysis of paired data found a statistically significant increase between pre- and post-test scores (p=0.0032) and in comfort levels with outpatient care (p=0.02), inpatient care (p=0.02), and starting new medications (p=0.026) in the intervention group compared with controls. Resident knowledge and comfort managing patients on HIV medications can be improved after a single targeted educational intervention. This topic should be prioritized within a broader HIV curriculum