Department of Chronic Disease Epidemiology, Yale School of Public Health, 135 College Street, New Haven, Connecticut, USA.
Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, Connecticut, USA.
J Int Assoc Provid AIDS Care. 2022 Jan-Dec;21:23259582221144451. doi: 10.1177/23259582221144451.
Pre-exposure prophylaxis (PrEP) is underused in the southern United States (US), a region with high HIV incidence. Clinical decision support (CDS) tools could increase PrEP prescriptions. We explored barriers to PrEP delivery and views of CDS tools to identify refinements for implementation strategies for PrEP prescribing and PrEP CDS tools. We conducted focus groups with health care providers from two federally qualified health centers in Alabama and analyzed the results using rapid qualitative methods. Barriers to PrEP included providers' lack of training in PrEP, competing priorities and time constraints during clinical visits, concerns about side effects, and intensive workload. We identified refinements to the planned implementation strategies to address the barriers, including training all clinic staff in PrEP and having CDS PrEP alerts in electronic health records sent to all staff. Development and deployment of CDS tools in collaboration with providers has potential to increase PrEP prescribing in high-priority jurisdictions.
暴露前预防（PrEP）在美国南部（美国）的使用率较低，该地区 HIV 发病率较高。临床决策支持（CDS）工具可以增加 PrEP 的处方量。我们探讨了提供 PrEP 的障碍以及对 CDS 工具的看法，以确定改进 PrEP 处方和 PrEP CDS 工具的实施策略。我们在阿拉巴马州的两个联邦合格的健康中心进行了医疗保健提供者的焦点小组，并使用快速定性方法分析了结果。PrEP 的障碍包括提供者缺乏 PrEP 培训、临床访问期间的优先事项和时间限制、对副作用的担忧以及繁重的工作量。我们确定了改进计划实施策略的方法，以解决这些障碍，包括对所有诊所工作人员进行 PrEP 培训，并在电子健康记录中向所有工作人员发送 CDS PrEP 警报。与提供者合作开发和部署 CDS 工具有可能增加高优先级司法管辖区的 PrEP 处方量。
