J Am Pharm Assoc (2003). 2020 Jan-Feb;60(1):138-144. doi: 10.1016/j.japh.2019.06.021. Epub 2019 Aug 9.
To discuss the design and implementation of a community pharmacy-initiated HIV pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) program developed in collaboration with the San Francisco Department of Public Health (SFDPH).
A community pharmacy in San Francisco and the SFDPH developed a collaborative practice agreement (CPA) that allowed community pharmacists to initiate PrEP and PEP to prevent HIV acquisition and increase uptake in vulnerable populations.
A community pharmacy in San Francisco's Mission District, an urban, historically Hispanic/Latino/Latinx neighborhood. The primary collaborative practice team consisted of 1 community pharmacy technician, 4 community pharmacists, and 1 designated overseeing physician at SFDPH.
The pharmacy and the SFDPH collaborated together for 20 months from start to implementation of the CPA and the PrEP program. An interdisciplinary team of pharmacists, pharmacy personnel, public health physicians, and health department staff members worked together to design, launch, and maintain the program. Pharmacists were trained by SFDPH staff members on HIV testing and counseling and implementation of the PrEP protocol, including PEP initiation and sexually transmitted disease testing. A Department of Public Health secure portal was used to share patient information. An SFDPH physician reviewed patients' charts regularly and communicated with PrEP pharmacists as needed.
Between April 2018 and the end of March 2019, 6 patients received PEP and 53 patients completed a PrEP initiation visit, of whom 96% (n = 51) filled their prescription. Approximately 47% (n = 24) of clients who started PrEP self-identified as Hispanic or Latino, 10% (n = 5) were black or African American, and 82% (n = 42) identified as men who have sex with men.
Implementation of a CPA between a community pharmacy and a local health department enabled the launch of pharmacist-delivered PrEP, further expanding the landscape of access points to vulnerable populations in San Francisco.
讨论与旧金山公共卫生部（SFDPH）合作开发的社区药房发起的 HIV 暴露前预防（PrEP）和暴露后预防（PEP）计划的设计和实施。
旧金山的一家社区药房和 SFDPH 制定了一份合作实践协议（CPA），允许社区药剂师启动 PrEP 和 PEP，以预防 HIV 感染，并增加弱势群体的接受度。
旧金山使命区的一家社区药房，这是一个城市，历史上是西班牙裔/拉丁裔/拉丁裔社区。主要的合作实践团队由 1 名社区药房技术员、4 名社区药剂师和 SFDPH 的 1 名指定监督医生组成。
从 CPA 和 PrEP 计划的启动到实施，药房和 SFDPH 合作了 20 个月。一个由药剂师、药房人员、公共卫生医生和卫生部门工作人员组成的跨学科团队共同设计、推出和维护该计划。SFDPH 工作人员对药剂师进行了 HIV 检测和咨询以及 PrEP 方案的实施培训，包括 PEP 启动和性传播疾病检测。公共卫生部门使用一个安全门户来共享患者信息。SFDPH 医生定期审查患者的图表，并根据需要与 PrEP 药剂师沟通。
2018 年 4 月至 2019 年 3 月底，有 6 名患者接受了 PEP，53 名患者完成了 PrEP 启动访问，其中 96%（n=51）患者的处方得到了填写。大约 47%（n=24）开始接受 PrEP 的患者自我认定为西班牙裔或拉丁裔，10%（n=5）为非裔美国人，82%（n=42）为男男性行为者。
社区药房与地方卫生部门之间的 CPA 的实施使药剂师提供的 PrEP 得以启动，进一步扩大了旧金山弱势群体获得服务的渠道。
