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Improving Participation in HIV Preexposure Prophylaxis via an Informatics Approach-a Process-Improvement Project.

Jeremy J Mandia¹, Case H Keltner¹, Robert C Haynes¹

¹At the time of project completion, all authors were with Madigan Army Medical Center, Tacoma, WA. Jeremy Mandia, Case Keltner, Robert Haynes, and Luke Mease were with the Department of Preventive Medicine; Lisa Cruz is with the Department of Family Medicine; and Keith Solveson is with the Department of Informatics.

American Journal of Public Health

|February 12, 2025

Summary

This summary is machine-generated.

Military health care beneficiaries with expired HIV preexposure prophylaxis prescriptions were re-engaged through a systematic electronic health record query. This proactive approach successfully increased patient re-engagement by 30%.

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Area of Science:

Public Health
Infectious Disease Prevention
Health Services Research

Background:

Maintaining adherence to preexposure prophylaxis (PrEP) is crucial for HIV prevention.
Expired prescriptions represent a missed opportunity for continuous HIV prevention among eligible individuals.
Active case management for medication adherence can be resource-intensive.

Purpose of the Study:

To re-engage military health care beneficiaries with expired HIV preexposure prophylaxis prescriptions.
To assess the feasibility and impact of using electronic health records (EHR) for proactive patient outreach.
To improve PrEP adherence and coverage within a military health system.

Main Methods:

A retrospective review of EHRs identified military health care beneficiaries with expired HIV PrEP prescriptions at Madigan Army Medical Center.
Patients with expired prescriptions were contacted via phone to assess HIV risk and discuss PrEP continuation.
Follow-up arrangements were made for patients with clinical indications for PrEP.

Main Results:

80% of patients with clinical indications for PrEP agreed to re-engage with services after outreach.
The initiative resulted in a 30% increase in the number of patients receiving PrEP at the institution.
Systematic EHR queries demonstrated effectiveness in reducing nonadherence.

Conclusions:

Proactive, systematic EHR queries can effectively identify and re-engage patients with expired PrEP prescriptions.
This approach can significantly improve PrEP adherence and coverage, especially when active case management is limited.
Utilizing EHR data is a valuable strategy for public health interventions in preventing HIV transmission.