Exploring workflows for long-acting antiretroviral therapy administration in community pharmacies

Area of Science:

• Pharmacology and Public Health
• HIV/AIDS Treatment and Prevention Strategies
• Healthcare System Optimization

Background:

• Long-acting injectable antiretroviral therapy (LA-ART) improves adherence and viral suppression in HIV patients.
• Implementation challenges exist in clinical settings, prompting exploration of alternative venues.
• Community pharmacies present a viable option for LA-ART administration, but optimal workflows require investigation.

Purpose of the Study:

• To identify key considerations for an ideal workflow for implementing LA-ART in community pharmacies.
• To gather perspectives from clinic, pharmacy, and patient stakeholders on LA-ART administration.
• To inform the development of scalable models for HIV treatment access.

Main Methods:

• Convergent-parallel mixed-methods study utilizing surveys and semi-structured interviews.
• Thematic analysis of stakeholder insights on ideal pharmacy workflows for LA-ART.
• Process mapping to visualize proposed pharmacy workflow activities.

Main Results:

• Seven themes emerged: stakeholder communication, staffing, patient management, insurance/reimbursement, physical space, education, and patient choice.
• Effective communication, appointment systems, and private spaces were crucial for ideal workflows.
• Challenges include unclear patient management protocols, insurance complexities, and the need for comprehensive education.

Conclusions:

• Community pharmacies are a promising setting for LA-ART administration.
• Addressing key workflow issues identified by stakeholders is essential for successful implementation.
• Understanding stakeholder perspectives facilitates the development of models to enhance access to HIV care.