Attitudes about community pharmacy access to HIV prevention medications in California.
Attitudes about community pharmacy access to HIV prevention medications in California.
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DOI：
10.1016/j.japh.2020.06.005
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Steward WT
中科院分区：
文献类型：
--
作者：
Koester KA;Saberi P;Fuller SM;Arnold EA;Steward WT
增加获得人类免疫缺陷病毒(艾滋病毒)暴露前预防(PrEP)和暴露后预防(PEP)是结束艾滋病毒流行倡议的高度优先事项。通过包括社区药房在内的各种卫生保健机构扩大获得PrEP和PEP的机会，可能会增加最需要帮助的社区的获得机会。加州是第一个允许社区药剂师直接向消费者提供PrEP和PEP的州。我们的目标是评估关键利益相关者对加州允许社区药剂师提供艾滋病毒、PrEP和PEP的政策的态度。我们与关键的药房利益相关者进行了定性的案例研究。半结构化电话采访被录音并逐字转录。我们为每次采访生成了分析性备忘录，并使用这些分析性备忘录进行了跨案例的持续比较，以确定共同点和不同点。我们于2018年10月启动了这项研究，采访了在各种环境中工作的药剂师(n=7)，包括零售、诊所和社区药店。我们还采访了在大容量PrEP诊所工作的医疗提供者(n=2)，并征求了大型零售连锁药店代表的意见(n=2)。总体而言，药剂师和医疗提供者信息者对药剂师提供的PrEP和PEP服务的核心好处以及关键挑战有着相似的看法。好处包括：社区药剂师随处可见，PrEP和PEP方案类似于其他预防性药物，政策可能会提高医疗保健工作人员的效率，社区药剂师是药物依从性的权威。挑战包括：实施问题可能限制药剂师的参与，以及错过诊断和治疗其他健康状况的机会。这项研究描述了当PrEP和PEP处方特权扩展到社区药剂师时可以预期的好处和挑战的类型。这些信息可能对政策制定者和其他考虑立法允许药剂师直接开出PrEP和PEP的利益攸关方有用。
Increasing access to human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) is a high priority for the Ending the HIV Epidemic Initiative. Expanding access to PrEP and PEP through a variety of health care settings, including community pharmacies, may increase access in communities most in need. California is the first state to allow community pharmacists to furnish PrEP and PEP directly to consumers. Our objective was to assess attitudes among key stakeholders about a California policy to allow community pharmacists to furnish HIV PrEP and PEP. We conducted a qualitative case study with key pharmacy stakeholders. Semi-structured phone interviews were audio-recorded and transcribed verbatim. We generated analytical memos for each interview and working with these analytical memos, we conducted a constant comparison across cases to identify commonalities and differences. We launched the study in October 2018 and interviewed pharmacists (n = 7) working in a variety of settings, including retail-, clinic-, and community-based pharmacies. We also interviewed medical providers (n = 2) working in high-volume PrEP clinics and sought input from representatives of large retail chain pharmacies (n = 2). Overall, pharmacists and medical provider informants shared similar opinions about the central benefits as well as the key challenges related to pharmacist-delivered PrEP and PEP services. Benefits included: community pharmacists are widely accessible, PrEP and PEP protocols are similar to other preventative medications, policy may lead to efficiencies in the health care workforce, and community pharmacists are authorities on medication adherence. Challenges included: implementation issues may limit pharmacist involvement, and missed opportunities to diagnose and treat other health conditions. This study characterizes the types of benefits and challenges that can be expected when PrEP and PEP prescribing privileges are extended to community pharmacists. This information may be useful to policymakers and other stakeholders considering legislation to permit direct prescription of PrEP and PEP by pharmacists.
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