Digital refill reminders, adherence and length of therapy amongHIV pre-exposure prophylaxis medication users

Hazen, Ron; Kirkham, Heather; Hou, Jingguo; Pietrandoni, Glen; Delpino, Ambrose

doi:10.1080/21556660.2018.1521097

Cited by 3 publications

(7 citation statements)

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“…Clients perceived the accessibility of community pharmacies in terms of location, speed of service and extended opening hours (42, 48, 56, 58, 62) to facilitate PrEP delivery, particularly if living in an urban area (48). Other important facilitators for clients were the presence of a private space to discuss and deliver PrEP to ensure confidentiality and respect (34, 40, 70), offering PrEP alongside other existing care pathways and services (e.g., opiate substitution therapy) and the presence of a pharmacist specialising in HIV service provision who could be easily identified (e.g., by their clothing) as the person to speak to about PrEP (40).…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…Believing that pharmacists were well trained to deliver PrEP (56) and that pharmacies were acceptable places to initiate and receive PrEP was also found to facilitate PrEP delivery (38, 56, 59). Other facilitators included PrEP being available free or at a low cost to clients (18, 34, 37, 48, 65), having insurance to cover the costs of PrEP (27), and believing that PrEP delivery in community pharmacies could circumvent the stigma associated with PrEP and HIV, in part by offering clients the opportunity to obtain PrEP discretely (42, 70, 71).…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

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Facilitators and barriers to community pharmacy PrEP delivery: A scoping review

Harrison,

Family,

Kesten

et al. 2023

Preprint

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IntroductionPre-exposure prophylaxis (PrEP) is an effective medication to reduce the risk of acquiring HIV. PrEP is available free of charge in the United Kingdom from sexual health clinics. Expanding PrEP delivery to community pharmacies holds promise and aligns with UK government goals to eliminate new cases of HIV by 2030. The aim of this scoping review was to describe the existing evidence about the barriers to and facilitators of community pharmacy PrEP delivery, for pharmacists and pharmacy clients, as aligned with the Capacity Opportunity, Motivation Behaviour (COM-B) Model.MethodsFive bibliographic and five review databases were searched from inception to August 2023. Literature of any study design was included if it discussed barriers and facilitators of community pharmacy PrEP delivery. Trial registrations, protocols and news articles were excluded.ResultsA total of 649 records were identified, 73 full texts were reviewed, and 56 met the inclusion criteria. Most of the included literature was original research (55%), from the United States of America (77%) conducted during or after the year 2020 (63%). Barriers to PrEP delivery for pharmacists included lack of knowledge, training and skills (capability), not having the necessary facilities (opportunity), concern about the costs of PrEP and believing that PrEP use could lead to risk behaviour’s and STIs (motivation). Facilitators included staff training (capability), time, the right facilities (opportunity), believing PrEP could be a source of profit and could reduce new HIV infections (motivation). For clients, barriers included lack of PrEP awareness (capability), pharmacy facilities (opportunity) and not considering pharmacists as healthcare providers (motivation). Facilitators included awareness of PrEP and pharmacist’s training to deliver it (capability), the accessibility of pharmacies (opportunity) and having an interest in PrEP (motivation).ConclusionTo effectively enhance PrEP delivery in UK community pharmacies, the identified barriers and facilitators should be explored for relevance in the UK and subsequently addressed and leveraged at the pharmacy team, client and care pathway level. By comprehensively considering all aspects of the COM-B framework, community pharmacies could become crucial providers in expanding PrEP accessibility, contributing significantly to HIV prevention efforts.

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Section: Synthesis Of Resultsmentioning

confidence: 99%

Section: Synthesis Of Resultsmentioning

confidence: 99%

Facilitators and barriers to community pharmacy PrEP delivery: A scoping review

Harrison,

Family,

Kesten

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…quality standards) and oversight (audits) to adhere to [34] Concern about medical complications [53] PharmD qualification (professional doctorate degree of pharmacy in the United States), fourth-year pharmacy students [51,52,54,56] Knowing pharmacists had specific training/education for PrEP [34,50] Less education (i.e. second-year pharmacy students) [54] Lack of PrEP guidelines [33] Able to make PrEP recommendations, order lab tests [43,57] Lack Hire staff/more staff on duty [34] Economic instability [62] Location and lack of transport [63] Location of pharmacy [64,65] Convenient location/proximity [56,59] Pharmacies convenient location, accessibility and/or quick service [50,53,66,67] Lack of staff time [31,34,35,37,53,58,68] Perceptions of increased pharmacist workload [50] Appointment systems [31,37] Attending specialized HIV service [66] Lack of physician oversight of PrEP initiation [61] PrEP expert present and identifiable [69] Use of pre-existing pathways/conversations [38,53] Use of existing pathways [70] Extended opening hours [39,61,…”

Section: Physicalmentioning

confidence: 99%

Facilitators and barriers to community pharmacy PrEP delivery: a scoping review

Harrison,

Family,

Kesten

et al. 2024

J Int AIDS Soc.

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IntroductionPre‐exposure prophylaxis (PrEP) is an effective medication to reduce the risk of acquiring HIV. PrEP is available free of charge in the UK from sexual health clinics. Expanding PrEP delivery to community pharmacies holds promise and aligns with UK government goals to eliminate new cases of HIV by 2030. The aim of this scoping review was to describe the existing evidence about the barriers to and facilitators of community pharmacy oral PrEP delivery, for pharmacists and pharmacy clients, as aligned with the Capacity Opportunity, Motivation Behaviour (COM‐B) Model.MethodsFive bibliographic and five review databases were searched from inception to August 2023. Literature of any study design was included if it discussed barriers and facilitators of community pharmacy PrEP delivery. Trial registrations, protocols and news articles were excluded.ResultsA total of 649 records were identified, 73 full texts were reviewed and 56 met the inclusion criteria, predominantly from high‐income/westernized settings. Most of the included literature was original research (55%), from the United States (77%) conducted during or after the year 2020 (63%). Barriers to PrEP delivery for pharmacists included lack of knowledge, training and skills (capability), not having the necessary facilities (opportunity), concern about the costs of PrEP and believing that PrEP use could lead to risk behaviours and sexually transmitted infections (motivation). Facilitators included staff training (capability), time, the right facilities (opportunity), believing PrEP could be a source of profit and could reduce new HIV acquisitions (motivation). For clients, barriers included a lack of PrEP awareness (capability), pharmacy facilities (opportunity) and not considering pharmacists as healthcare providers (motivation). Facilitators included awareness of PrEP and pharmacist's training to deliver it (capability), the accessibility of pharmacies (opportunity) and having an interest in PrEP (motivation).DiscussionTo effectively enhance oral PrEP delivery in UK community pharmacies, the identified barriers and facilitators should be explored for UK relevance, addressed and leveraged at the pharmacy team, client and care pathway level.ConclusionsBy comprehensively considering all aspects of the COM‐B framework, community pharmacies could become crucial providers in expanding PrEP accessibility, contributing significantly to HIV prevention efforts.

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“…[18][19][20][21] Some community pharmacies have implemented specialized services including prescription delivery, refill reminders, medication therapy management (MTM) services, and insurance assistance to promote adherence for people on HIV treatment and prevention medications. [22][23][24][25][26][27][28][29][30] Additionally, some community pharmacies are staffed with pharmacists specially trained in HIV care. Communitybased pharmacists are well positioned to assist with HIV adherence and care because community pharmacies are often within five miles of 88.9% of Americans, they have frequent interactions with patients, and have easy access to prescription refill information.…”

Section: Introductionmentioning

confidence: 99%

“…Pharmacists, as medication experts, can improve adherence to ARV therapy and clinical outcomes for both HIV treatment and prevention 18–21 . Some community pharmacies have implemented specialized services including prescription delivery, refill reminders, medication therapy management (MTM) services, and insurance assistance to promote adherence for people on HIV treatment and prevention medications 22–30 . Additionally, some community pharmacies are staffed with pharmacists specially trained in HIV care.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of adherence to antiretroviral medications in a supermarket‐based community pharmacy

Loi

Tran

Seung

et al. 2023

J Am Coll Clin Pharm

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IntroductionA critical aspect of human immunodeficiency virus (HIV) infection management and prevention is adherence to antiretroviral (ARV) medications. There are limited recent studies focused on the impact of community pharmacy interventions on ARV adherence; previous studies were conducted between 2004 and 2012 with more complicated regimens.ObjectivesThe primary objective was to compare the adherence rates for ARV medications for both HIV treatment and prevention in patients using HIV‐focused (HIV‐F) pharmacies compared with traditional (non‐HIV focused) pharmacies in a supermarket‐based community pharmacy. The secondary objectives were to determine which factors impact adherence rates as well as the demographic information of patients using HIV‐F pharmacies.MethodsThis was a retrospective study of de‐identified pharmacy dispensing data for patients filling ARV medications from October 2018 to July 2021 at a Safeway pharmacy in the Washington D.C., Maryland, and Virginia (DMV) area. Patients 18 years and older who had fill records at a Safeway pharmacy in the DMV area of at least two 30‐day supplies of ARV medication were included. For all eligible patients, medication adherence was measured by assessing the proportion of days covered (PDC).ResultsOf the 1496 patients who met the inclusion criteria, 971 patients used an HIV‐F pharmacy. Overall, patients were predominantly male (78.9%) with a median age of 44 years. The median PDC score of HIV‐F pharmacies was higher than traditional pharmacies, but the difference was not statistically significant (97.1% vs. 96.6%, respectively, p = 0.2).ConclusionPatients using this regional division supermarket‐based community pharmacy have a high PDC score regardless of pharmacy type. Use of newer ARV agents may have facilitated patients' adherence and diminished the potential benefit of utilizing HIV‐F pharmacies. Pharmacies currently providing specialized patient care for ARV medications may need to re‐evaluate how best to promote medication adherence.

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Digital refill reminders, adherence and length of therapy amongHIV pre-exposure prophylaxis medication users

Cited by 3 publications

References 0 publications

Facilitators and barriers to community pharmacy PrEP delivery: A scoping review

Facilitators and barriers to community pharmacy PrEP delivery: A scoping review

Facilitators and barriers to community pharmacy PrEP delivery: a scoping review

Evaluation of adherence to antiretroviral medications in a supermarket‐based community pharmacy

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