Scarnati Kaylee, Esser Katherine L, Sim Julianna M, Vaidya Varun, Sahloff Eric, Duggan Joan
University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
University of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, OH, USA.
J Community Health. 2025 Apr;50(2):335-343. doi: 10.1007/s10900-024-01421-x. Epub 2024 Dec 4.
Timely initiation of antiretroviral therapy (ART) for non-occupational post-exposure prophylaxis (nPEP) is crucial in preventing HIV infection and advancing efforts to end the HIV epidemic (EHE). nPEP must be administered within 72 h of high-risk exposure, ideally within 24 h. Pharmacies may play a role in increasing access to nPEP and facilitating referrals for additional care, such as PrEP. Recent legislation permits pharmacist-prescribed nPEP (PDP), though provider attitudes toward this change have not been studied. A survey querying physicians and medical trainees (students and residents) was conducted in 2024 during an annual state medical association conference. The survey included 24 questions on nPEP knowledge and attitudes towards pharmacist-prescribed nPEP (PDP). The survey was administered in person using electronic tablets, with voluntary participation incentivized by a monetary reward. Statistical analysis was conducted using SAS (9.4 version) software, with differences in responses between physicians and trainees evaluated. P values < 0.05 were considered statistically significant. Of 89 respondents (56% of attendees), 61 were physicians and 28 were trainees. Notably, 28% of licensed providers indicated that pharmacist-directed prescribing (PDP) should not be allowed in the State of Ohio, while no trainees expressed this same opposition (p = 0.001). Trainees were more likely to view pharmacist prescribing as safe and appropriate ((p = 0.0135, p = 0.013). Urban-based providers were more supportive of pharmacist prescribing than their rural counterparts (p = 0.0195). Trainees showed little opposition to PDP, whereas physicians expressed concerns about safety and appropriateness. Addressing these concerns is essential for integrating pharmacists into the EHE strategy.
及时启动非职业性暴露后预防(nPEP)的抗逆转录病毒疗法(ART)对于预防HIV感染以及推进终结HIV流行(EHE)的工作至关重要。nPEP必须在高危暴露后72小时内给药,理想情况是在24小时内。药房在增加nPEP的可及性以及促进转介接受额外护理(如暴露前预防)方面可能发挥作用。最近的立法允许药剂师开具nPEP处方(PDP),不过尚未研究医疗服务提供者对这一变化的态度。2024年在一次年度州医学协会会议期间对医生和医学实习生(学生和住院医师)进行了一项调查。该调查包括24个关于nPEP知识以及对药剂师开具nPEP处方(PDP)态度的问题。调查通过电子平板电脑进行现场发放,以金钱奖励激励自愿参与。使用SAS(9.4版本)软件进行统计分析,评估医生和实习生之间的回答差异。P值<0.05被认为具有统计学意义。在89名受访者(占参会者的56%)中,61名是医生,28名是实习生。值得注意的是,28%的有执照医疗服务提供者表示俄亥俄州不应允许药剂师指导下的处方开具(PDP),而没有实习生表达同样的反对意见(p = 0.001)。实习生更有可能认为药剂师开具处方是安全且合适的((p = 0.0135,p = 0.013)。与农村地区的医疗服务提供者相比,城市地区的医疗服务提供者对药剂师开具处方更为支持(p = 0.0195)。实习生对PDP几乎没有反对意见,而医生则对安全性和适宜性表示担忧。解决这些担忧对于将药剂师纳入EHE战略至关重要。