1320. Continuing Education Improves HIV Screening and Use of PrEP in High-Risk Patients
Session: Poster Abstract Session: Medical Education
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • Robinson_Katie_ID Week Poster 2018_FINAL.pdf (449.3 kB)
  • Background: Since approval in 2012, the uptake of PrEP in high-risk patients remains low, especially among primary care providers (PCPs) who lack knowledge and confidence regarding its use. Continuing education (CE) has been extensively used to address such knowledge and practice gaps, yet little evidence exists supporting the impact of these initiatives on direct patient care and cost.

    Methods: Vindico Medical Education partnered with Improve CME to assess the impact of 7 CE programs targeted to PCPs from 2015-2017 regarding the use of PrEP in high-risk patients. An outcomes analysis model was used and designed to estimate 1) patients newly identified as HIV+ or HIV-, 2) patients newly on PrEP or HIV treatment, and 3) associated costs of care due to the CE.

    Results: Prescribing providers (n=4,550) who each see an average of 16.8 patients at high-risk for HIV infection per month, participated. Prior to learning only 44% of participants reported that they frequently offer HIV testing to high-risk patients; and only 13% frequently use PrEP clinical guidelines. Six-months post-education, however, 83% and 68% of providers reported using HIV testing and PrEP guidelines, respectively. We then used evidence-based parameters to project the number of high-risk patients who, based on our pool of patients directly impacted by the education, would be willing to accept an HIV test, those who would be HIV+ versus HIV-, and those who would be willing to accept and adhere to either HIV treatment or PrEP. The model estimated that over the course of 1 year, 135,941 high-risk patients would be newly offered an HIV test. Of those accepting the test (n=54,376), 163 would be newly identified as HIV+. Of the 54,213 newly-identified as HIV-, at least 3,914 would be placed on PrEP. Using accepted values for direct cost of care, this translates to $1.26 mil per year for patients newly treated for HIV and $92.4 mil per year for those patients newly on PrEP.

    Conclusion: Targeted CE to PCPs increased screening rates for HIV infection in high-risk patients, increased awareness and use of PrEP, and linked patients with appropriate care. These findings validate the need for ongoing CE programs to address persisting unmet needs and show that modeling can be used to estimate patient outcomes from CE programs.

    Katie Robinson, PhD1, Derek Dietze, MA2, Robert Esgro, MA1 and Richard Elion, MD3, (1)Vindico Medical Education, Thorofare, NJ, (2)Improve CME, Queen Creek, AZ, (3)Whitman Walker Clin., Washington, DC

    Disclosures:

    K. Robinson, None

    D. Dietze, None

    R. Esgro, None

    R. Elion, gilead: Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee , Research support and Speaker honorarium . ViiV: Consultant , Consulting fee .

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