1294. Acceptability and Feasibility of a Pharmacist-led Pre-exposure Prophylaxis Program in the Midwestern United States
Session: Poster Abstract Session: HIV: Prevention
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • FINAL P-PrEP IDWeek 2018.pdf (1010.5 kB)
  • Background: Despite evidence that HIV pre-exposure prophylaxis (PrEP) substantially reduces the risk of infection in at-risk populations, significant barriers exist to its prescription and use. Utilizing pharmacists may help increase patient access to PrEP services. We designed and implemented a novel pharmacist-led PrEP program in Omaha, Nebraska.

    Methods: Our pharmacist-led PrEP program was developed in the fall of 2016. Six pharmacists from 4 sites (1 community pharmacy, 2 community-based clinics and 1 HIV-specialized clinic) were selected for participation based on interest, senior management support, and availability of appropriate infrastructure. All pharmacists received training for the provision of PrEP. Through a collaborative practice agreement, pharmacists met with patients individually, obtained a medical history, performed a risk assessment and point-of-care laboratory testing (HIV screen, creatinine and syphilis), and collected samples for gonorrhea and chlamydia. They also provided medication and adherence counseling, and prescribed emtricitabine-tenofovir DF when appropriate. Pharmacists completed a survey reporting their experience after each visit. Presented here are patient demographics, retention rates, and pharmacist-reported experience from the first 6 months of the program.

    Results: Sixty patients enrolled in the pharmacist-led PrEP program between January and June 2017 and completed 139 visits. 95% of participants were men, 83% were white, 80% were privately insured, and 90% had completed some college or higher. The mean age of participants was 34 years (range 20-61 years) and 88% identified as men who have sex with men. 73% were retained in care at 3 months and 58% were retained in care at 6 months. To date, no patient has seroconverted. Pharmacists reported feeling comfortable performing point-of-care testing at all visits and only reported feeling uncomfortable counseling patients on 3 occasions (2.2%). Finally, pharmacist-reported workflow disruption only occurred on 1 occasion (0.7%).

    Conclusion: Implementation of a pharmacist-led PrEP program is feasible, associated with high rates of pharmacist acceptability, and results in retention rates that are comparable to other real-world PrEP programs.

    Sara Bares, MD, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, Joshua Havens, PharmD, Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, Kimberly Scarsi, PharmD, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, Donald Klepser, PhD, MBA, University of Nebraska Medical Center College of Pharmacy, Omaha, NE and Susan Swindells, MBBS, Univ. of Nebraska Med. Ctr., Omaha, NE

    Disclosures:

    S. Bares, Gilead: Grant Investigator , Grant recipient .

    J. Havens, None

    K. Scarsi, None

    D. Klepser, None

    S. Swindells, Merck: Investigator , Research support . ViiV: Investigator , Research support .

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