Pharmacy staff willingness to establish pre-exposure prophylaxis-based collaborative practice agreements in the...

A collaborative practice agreement (CPA) allows a pharmacist to provide various patient care functions (i.e., ordering labs and modifying drug therapies) under the supervision of a provider. CPAs could facilitate pharmacists to provide human immunodeficiency virus (HIV) prevention services such as pre-exposure prophylaxis screening and prescribing, which could enhance HIV prevention services in places with historically low access.

We evaluate correlates of pharmacy staff willingness to establish CPAs and to provide specific patient care functions.

The Collaborative Agreement-based pre-exposure prophylaxis Using Pharmacists study conducted online surveys among pharmacy staff from 8 states in the Southeast United States. Data collection began in January 2024 and is ongoing. Survey questions were developed using Consolidated Framework for Implementation Research constructs and capture the history of CPA usage, attitudes about CPAs, and willingness to establish CPAs. Descriptive analysis and Poisson regression were performed using preliminary data to evaluate pharmacy staff willingness to offer specific patient care functions through CPAs.

Among 246 respondents, 67 (27%) currently have at least 1 CPA in place, with 20 (30%) of those CPAs involving infectious disease care. About 75% were willing to establish a CPA to provide additional services to their patients. Most pharmacy staffs were willing to provide medication therapy management (91%), patient counseling (82%), and modification of existing therapy (73%); fewer were willing to interpret laboratory tests (54%), order laboratory tests (52%), and perform laboratory tests (39%). The strongest correlate of willingness to establish a CPA was having received formal training on CPAs.

Most pharmacy staffs were willing to establish CPAs to provide additional services beyond their current scope of practice, but few have experience with infectious disease CPAs. Future research is needed to identify factors that will allow for successful development and implementation of HIV prevention-specific CPAs and understand barriers to willingness for pharmacy staff who are unwilling to establish CPAs.