Impact of an Intervention to Expand Pharmacist Capacity to Prescribe HIV Pre-exposure Prophylaxis

Modified Abstract Section ABSTRACT Significance: HIV Pre-exposure Prophylaxis (PrEP) access and uptake are highly variable among individuals at increased risk of contracting the infection. The accessibility of community pharmacies and patient trust in pharmacists suggest that pharmacists can contribute significantly to increasing PrEP use. Pharmacist-led PrEP programs are expanding in the United States, with positive outcomes in PrEP initiation and retention in care for those taking PrEP. Despite great potential for pharmacy-based PrEP care, no specific intervention has been designed to improve pharmacists' capacity to prescribe PrEP. Candidate: I am a Ph.D.-level pharmacist with a strong foundation in general pharmacy-related research; however, my research interests have pivoted in recent years to HIV prevention and treatment. My long-term goal is to become an independent NIH-funded clinical investigator focused on developing and implementing pharmacy-based interventions to improve access to and uptake of HIV prevention and treatment. I am therefore pursuing additional mentored training in key areas for this new career path. Training aims: I propose training in (1) designing and conducting qualitative research using implementation science frameworks; (2) evidence-based intervention adaptation; (3) simulation-based learning in healthcare research; and (4) designing and executing clinical trials. Mentor team: Dr. Jessica Haberer (primary mentor; clinical trials), Dr. Sheree Schwartz (implementation science), Dr. Nao Hagiwara (social psychology), and Dr. Christina Psaros (qualitative methods). Advisor team: Dr. Musie Ghebremichael (statistical methods), Dr. Aleda Chen (social and behavioral aspects of pharmacy practice), and Dr. Samreen Vora (simulation). Research aims: The primary goal of this proposal is to determine the feasibility, acceptability, and preliminary impact of an adapted evidence-based intervention to improve the capacity of community pharmacists to prescribe PrEP. In Aim 1, I will use a qualitative approach with an implementation framework to elicit the opinions of pharmacy interns, pharmacy managers, and policymakers on relevant factors for implementing the evidence-based intervention. In Aim 2, I will use Aim 1 data to adapt the intervention to fit community pharmacy settings. In Aim 3, I will conduct a pilot trial with 70 pharmacy interns who will be randomized 1:1 to the adapted intervention vs an attention-matched control to test the feasibility, acceptability, and preliminary impact of the adapted intervention on changing behavior around PrEP prescribing practices. I will also obtain feedback on the trial findings interviews of pharmacy managers and policymakers. Impact: Based on my solid foundation in pharmacy practice research, an outstanding multidisciplinary mentoring team, a strong institutional commitment, and this innovative area of research, I am well-positioned to complete this project, achieve my training goals, and become an independent clinical investigator committed to improving access to HIV prevention and treatment in pharmacy practice settings.