Pharmacist-delivered HIV point-of-care testing in Ontario: Lessons learned from the GetaTest pilot

Winkelman, Steven; Inamdar, Gauri; Kesler, Maya; Kelly, Deborah; Somani, Zahid; Ho, Justin; Somani, Taslim; Gunter, Ben; Tran, Lisa; English, Ken; Musten, Alexandra

doi:10.1177/17151635221128001

Cited by 2 publications

(4 citation statements)

References 16 publications

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“…Pharmacists who offer HIV testing receive training in the practical administration of the test as well as in counseling and linkage to care, which support their confidence and willingness to provide HIV testing and counseling [10,12,42]. More importantly, patients express their high satisfaction with and trust in pharmacists providing this service [10,12,43]. A recent study reported that 99% of patients agreed HIV POCT should be routinely offered in pharmacies and 78% were willing to pay for the service [10].…”

Section: Discussionmentioning

confidence: 97%

“…To the extent that increase in test uptake with POCT may be higher than that used in our study, our cost-effectiveness estimates may be conservative. Second, consistent with care linkage rates after POCT at community pharmacies in Canada [9,43], our base case analysis assumed perfect care linkage after POCT. A previous study reported lower care linkage rates of 85% after POCT at pharmacies in the US [10].…”

Section: Discussionmentioning

confidence: 99%

“…A recent study reported that 99% of patients agreed HIV POCT should be routinely offered in pharmacies and 78% were willing to pay for the service [10]. They also said that getting POCT testing at a pharmacy was convenient and discreet, and that the pharmacist was supportive and provided effective education about how to reduce their future risk [10,41,43].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Estimated cost-effectiveness of point-of-care testing in community pharmacies vs. self-testing and standard laboratory testing for HIV

Mital

Kelly

Hughes

et al. 2023

Aids

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Objective:Point-of-care-testing (POCT) for HIV at community pharmacies can enhance care linkage compared with self-tests and increase testing uptake relative to standard lab testing. While the higher test uptake may increase testing costs, timely diagnosis and treatment can reduce downstream HIV treatment costs and improve health outcomes. This study provides the first evidence on the cost-effectiveness of pharmacist-led POCT vs. HIV self-testing and standard lab testing.Design:Dynamic transmission modelMethods:We compared three HIV testing strategies: POCT at community pharmacies; self-testing using HIV self-test kits; and standard lab testing. Analyses were conducted from the Canadian health system perspective over a 30-year time horizon for all individuals aged 15–64 years in Canada. Costs were measured in 2021 Canadian dollars and effectiveness was captured using quality-adjusted life-years (QALYs).Results:Compared with standard lab testing, POCT at community pharmacies would save $885 million in testing costs over 30 years. Though antiretroviral treatment costs would increase by $190 million with POCT as more persons living with HIV are identified and treated, these additional costs would be partly offset by their lower downstream healthcare utilization (savings of $150 million). POCT at community pharmacies would also yield over 5000 additional QALYs. Compared with HIV self-testing, POCT at community pharmacies would generate both higher costs and higher QALYs and would be cost-effective with an incremental cost-effectiveness ratio of $47 475 per QALY gained.Conclusions:Offering POCT at community pharmacies can generate substantial cost savings and improve health outcomes compared with standard lab testing. It would also be cost-effective vs. HIV self-testing.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Estimated cost-effectiveness of point-of-care testing in community pharmacies vs. self-testing and standard laboratory testing for HIV

Mital

Kelly

Hughes

et al. 2023

Aids

View full text Add to dashboard Cite

show abstract

“…), infectious diseases (e.g., COVID-19, HIV, etc. ), and people’s health awareness, there is a significant demand for point-of-care testing (POCT). − Venous blood collection methods must be performed by well-trained medical workers, making it difficult to utilize these methods in a resource-limited setting, while the fingertip blood test makes it possible for individuals to collect their blood samples, which reduce the barriers to their usage. Thus, fingertip blood tests may be more popular in the era of personalized medicine.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Pairwise Venous and Fingertip Plasma Using Quantitative Proteomics Based on Data-Independent Acquisition

Huang

et al. 2023

J. Proteome Res.

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Blood contains a great deal of health-related information and can be used to monitor human health status. Clinically, venous or fingertip blood is usually used for blood tests. However, the clinical application settings of the two sources of blood are unclear. In this study, the proteomes of pairwise venous plasma (VP) and fingertip plasma (FP) were analyzed, and the levels of 3797 proteins were compared between VP and FP. The Spearman's correlation coefficient for the relationship between protein levels of VP and FP ranges from 0.64 to 0.78 (p < 0.0001). The common pathways of VP and FP are related to cell−cell adhesion, protein stabilization, innate immune response, and complement activation, the classical pathway. The VP-overrepresented pathway is related to actin filament organization, while the FP-overrepresented pathway is related to the hydrogen peroxide catabolic process. ADAMTSL4, ADIPOQ, HIBADH, and XPO5 both in VP and FP are potential gender-related proteins. Notably, the VP proteome has a higher interpretation on age than the FP proteome, and CD14 is a potential age-related protein in VP but not in FP. Our study mapped the different proteomes between VP and FP, which can provide value for the standardization of clinical blood tests.

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Pharmacist-delivered HIV point-of-care testing in Ontario: Lessons learned from the GetaTest pilot

Cited by 2 publications

References 16 publications

Estimated cost-effectiveness of point-of-care testing in community pharmacies vs. self-testing and standard laboratory testing for HIV

Estimated cost-effectiveness of point-of-care testing in community pharmacies vs. self-testing and standard laboratory testing for HIV

Comparison of Pairwise Venous and Fingertip Plasma Using Quantitative Proteomics Based on Data-Independent Acquisition

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