为基于药房的长效注射抗逆转录病毒药物配送做准备：一项实施前研究。
Preparing for pharmacy-based delivery of long-acting injectable antiretrovirals: a pre-implementation study.
作者信息
Cocohoba Jennifer, Cuca Yvette, Sherman Elizabeth, Hester Kelly, Udeani George, Sigua Michael, Saberi Parya
机构信息
Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, 521 Parnassus Avenue, C-152, Box 0622, San Francisco, CA, 94143, USA.
Department of Community Health Systems, University of California San Francisco School of Nursing, 490 Illinois Street, Floor, Box 0608, San Francisco, CA, 94143, USA.
出版信息
BMC Health Serv Res. 2025 Jun 5;25(1):808. doi: 10.1186/s12913-025-12971-8.
BACKGROUND
Use of long-acting injectable antiretroviral therapy (LA-ART) for human immunodeficiency virus (HIV) treatment and prevention is increasing, but there are challenges that could limit broad expansion of these important treatments. The goal of this study was to explore attitudes, barriers, and facilitators for implementing LA-ART administration within community pharmacies.
METHODS
We conducted a mixed-methods study focusing on pre-implementation aspects of community pharmacy-administered LA-ART. Pharmacists, clinic staff members, and persons with HIV completed a baseline survey followed by an individual semi-structured qualitative interview with questions based on the Consolidated Framework for Implementation Research (CFIR v.1.0).
RESULTS
A total of 63 participants (pharmacist = 19, clinic staff = 20, person with HIV = 24) from Alabama, California, Florida, and Texas were included in the study. Most pharmacist participants were employed in retail pharmacies that processed fewer than 500 prescriptions per day (75%) and most had more than 10 years of experience working with people with HIV (53%). Clinic staff participants were also highly experienced in working with people with HIV (55%). People with HIV enrolled in the study were either on oral antiretroviral therapy but interested in LA-ART (59%) or were already on LA-ART (29%). Clinics were the preferred location for LA-ART administration while community pharmacy was the second preferred location. Attitudes regarding pharmacy-based administration of LA-ART were mostly positive, with the primary facilitator being positive experiences or established relationships between clinics and pharmacies or persons with HIV and their pharmacies. Barriers included concerns about pharmacy staffing, training, space, privacy, and pharmacy reimbursement for services.
CONCLUSION
Involving community pharmacies in the administration of LA-ART could expand access to HIV treatment and prevention medications. Outlining best practices that leverage facilitators and overcome barriers can help clinics, pharmacy, and communities expand this novel model of care.
TRIAL REGISTRATION
ClinicalTrials.Gov Registration: NCT05152953 (posted 12/10/2021).
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s12913-025-12971-8.
背景
长效注射用抗逆转录病毒疗法（LA-ART）在人类免疫缺陷病毒（HIV）治疗和预防中的应用正在增加，但存在一些挑战可能会限制这些重要治疗方法的广泛推广。本研究的目的是探讨在社区药房实施LA-ART给药的态度、障碍和促进因素。
方法
我们开展了一项混合方法研究，重点关注社区药房实施LA-ART的实施前情况。药剂师、诊所工作人员和HIV感染者完成了一项基线调查，随后进行了一次基于实施研究综合框架（CFIR v.1.0）的个人半结构化定性访谈。
结果
来自阿拉巴马州、加利福尼亚州、佛罗里达州和得克萨斯州的63名参与者（药剂师=19名，诊所工作人员=20名，HIV感染者=24名）纳入了本研究。大多数药剂师参与者受雇于每天处理处方少于500张的零售药房（75%），且大多数人有超过10年与HIV感染者打交道的经验（53%）。诊所工作人员在与HIV感染者打交道方面也经验丰富（55%）。参与研究的HIV感染者要么正在接受口服抗逆转录病毒疗法但对LA-ART感兴趣（59%），要么已经在接受LA-ART治疗（29%）。诊所是LA-ART给药的首选地点，而社区药房是第二选择。对基于药房的LA-ART给药的态度大多是积极的，主要促进因素是诊所与药房之间或HIV感染者与其药房之间的积极经验或既定关系。障碍包括对药房人员配备、培训、空间、隐私以及药房服务报销的担忧。
结论
让社区药房参与LA-ART给药可以扩大获得HIV治疗和预防药物的机会。概述利用促进因素并克服障碍的最佳做法有助于诊所、药房和社区推广这种新型护理模式。
试验注册
ClinicalTrials.Gov注册号：NCT05152953（2021年12月10日发布）。
补充信息
在线版本包含可在10.1186/s12913-025-12971-8获取的补充材料。
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