Midwest pharmacists’ familiarity, experience, and willingness to provide pre-exposure prophylaxis (PrEP) for HIV

Abstract

IntroductionPharmacist provision of pre-exposure prophylaxis (PrEP) through collaborative practice agreements with physicians could expand access to people at risk for HIV. We characterized pharmacists’ familiarity with and willingness to provide PrEP services in Nebraska and Iowa.MethodsAn invitation to complete an 18-question survey was emailed to 1,140 pharmacists in Nebraska and Iowa in June and July of 2016. Descriptive analyses and Pearson chi-square tests were used to determine to what extent demographics, familiarity and experience were associated with respondent willingness to provide PrEP. Wilcoxon rank-sum tests compared ages and years of experience between groups of respondents.ResultsOne hundred forty pharmacists (12.3%) responded. Less than half were familiar with the use of PrEP (42%) or the CDC guidelines for its use (25%). Respondents who were older (p = .015) and in practice longer (p = .005) were less likely to be familiar with PrEP. Overall, 54% indicated they were fairly or very likely to provide PrEP services as part of a collaborative practice agreement and after additional training. While familiarity with PrEP use or guidelines did not affect respondents’ willingness to provide PrEP, respondents were more likely to provide PrEP with prior experience counseling HIV-infected patients on antiretroviral therapy (OR 2.43; p = 0.023) or PrEP (OR 4.67; p = 0.013), and with prior HIV-related continuing education (OR 2.77; p = 0.032).ConclusionsPharmacist respondents in Nebraska and Iowa had limited familiarity and experience with PrEP, but most indicated willingness to provide PrEP through collaborative practice agreements after additional training. Provision of PrEP-focused continuing education may lead to increased willingness to participate in PrEP programs.

A Narrative Review of Continuing Professional Development Needs for Pharmacists with Respect to Pre-exposure Prophylaxis (PrEP) for Human Immunodeficiency Virus (HIV)

“…Only 21% of all respondents reported they had sufficient knowledge to counsel patients on a PrEP prescription. Similar to Broekhuis et al, this study also found older participants to report less knowledge than younger ones [12,14]. Yoong et al studied PrEP awareness in Canadian HIV pharmacists and found that 94% of those surveyed were somewhat familiar or very familiar with the concept of PrEP [15].…”

“…This compared with only 17% of physicians. Broekhuis et al found that 42% of midwest pharmacists in the United States were familiar with the use of PrEP but only 25% were familiar with the CDC guidelines for its use [12]. This study also found that older pharmacists were less familiar with PrEP.…”

“…A common theme identified from the studies included in the review was that younger pharmacists and those with a PharmD degree had more knowledge and confidence and greater intentions to provide PrEP related services [12][13][14]17]. As the PharmD degree is the current entry-to-practice degree for the United States, it is likely that these two findings are inter-related, with PharmD holders being younger in general.…”

“…Six studies reported outcomes related to pharmacists' comfort and/or confidence in performing professional activities relating to PrEP. Broekhuis et al found >80% of Midwest pharmacists were comfortable assessing HIV risk, performing and counseling on HIV testing and providing counseling on PrEP use [12]. If necessary, however, 30% were not comfortable performing urine-based pregnancy and/or STI testing.…”

“…Seven studies reported outcomes relating to pharmacists/intentions and/or experiences for provision of PrEP therapy. Broekhuis et al reported 12% of Midwest pharmacists had previously counseled on PrEP [12]. A total of 54% indicated they were likely to provide PrEP services.…”