优化HIV PrEP持久性:你的药房是否重要?
Kristen Whelchel1, Autumn D Zuckerman2, Josh DeClercq3
1Department of Pharmaceutical Services, Vanderbilt University Medical Center, 726 Melrose Ave, Nashville, TN, 37211, USA. kristen.w.whelchel@vumc.org.
AIDS and behavior
|June 2, 2023
概括
综合卫生系统专业药房 (HSSP) 提高了对人类免疫缺陷病毒 (HIV) 暴露前预防 (PrEP) 的坚持. 与使用外部药房的患者相比,通过HSSP补充PrEP的患者表现出明显更高的持续率.
科学领域:
- 公共卫生 公共卫生
- 药学流行病学 药学流行病学
- 预防传染病 预防传染病
背景情况:
- 坚持人类免疫缺陷病毒 (HIV) 暴露前预防 (PrEP) 非常重要,以预防新的HIV感染.
- 在现实世界中,PrEP的遵守率仍然低于最佳水平,因此需要研究有效的输送策略.
- 综合卫生系统专业药房 (HSSP) 可能提供一种新的方法来提高PrEP的坚持.
研究的目的:
- 为了比较使用综合卫生系统专业药房 (HSSP) 和使用外部药房的患者之间的PrEP持久性.
- 在现实环境中确定影响PrEP持续性的因素.
主要方法:
- 在单个中心进行回顾性队列研究.
- 基于药房类型 (HSSP与外部) 的PrEP持久性的比较.
- 使用Kaplan-Meier生存分析和Cox比例危险建模来评估持久性.
主要成果:
- 与非HSSP队列相比,通过HSSP补充PrEP的患者在6,12和18个月内表现出明显更高的持久性概率 (例如,18个月持久性:0.64与0.32).
- 逻辑等级测试表明两组之间持久性有显著差异 (p < 0.001).
- 考克斯PH模型显示,使用非HSSP与非持久性增加2.7倍的可能性有关 (HR2.7,p < 0.001).
结论:
- 通过综合卫生系统专业药房分发PrEP与显著改善患者持久性有关.
- HSSP模型代表了一种有希望的策略,可以增强对PrEP的坚持,并优化艾滋病毒预防工作.
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