J Am Pharm Assoc (2003). 2020 Nov-Dec;60(6):e179-e183. doi: 10.1016/j.japh.2020.06.005. Epub 2020 Jul 12.
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. Semistructured 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.
增加人类免疫缺陷病毒 (HIV) 暴露前预防 (PrEP) 和暴露后预防 (PEP) 的可及性是终结艾滋病流行倡议的一个高度优先事项。通过各种医疗保健环境，包括社区药店，扩大 PrEP 和 PEP 的可及性，可以增加最需要的社区的可及性。加利福尼亚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利福尼亚州允许社区药剂师提供 HIV PrEP 和 PEP 的政策的态度。
我们对主要的药房利益相关者进行了定性案例研究。半结构化电话访谈进行了录音，并逐字转录。我们为每次访谈生成了分析备忘录，并使用这些分析备忘录，对案例进行了持续比较，以确定共同点和差异。
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。我们还采访了在高容量 PrEP 诊所工作的医疗服务提供者（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，药剂师和医疗服务提供者的信息提供者对与药剂师提供的 PrEP 和 PEP 服务相关的核心利益以及关键挑战有类似的看法。利益包括：社区药剂师广泛可及、PrEP 和 PEP 方案与其他预防性药物相似、政策可能导致医疗保健劳动力效率提高、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。
这项研究描述了将 PrEP 和 PEP 处方权扩展到社区药剂师时可能预期的利益和挑战的类型。这些信息可能对考虑允许药剂师直接开具 PrEP 和 PEP 处方的立法的政策制定者和其他利益相关者有用。
