Using Health Care Professionals’ Perspectives to Refine a Clinical Decision Support Implementation Strategy for Increasing the Prescribing of HIV Preexposure Prophylaxis (PrEP) in Alabama
Pre-exposure prophylaxis (PrEP) is underused in the southern United States (US), a region with high HIV incidence. Clinical decision support (CDS) tools could increase PrEP prescriptions. We explored barriers to PrEP delivery and views of CDS tools to identify refinements for implementation strategi...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-12-01
|
| Series: | Journal of the International Association of Providers of AIDS Care |
| Online Access: | https://doi.org/10.1177/23259582221144451 |
| _version_ | 1828114591418155008 |
|---|---|
| author | Debbie L. Humphries PhD, MPH, MA Elizabeth C. Rhodes PhD, MS Christine L. Simon ScD, SM Victor Wang BA Donna Spiegelman ScD Corilyn Ott PhD David Hicks DO, MPH Julia L. Marcus PhD, MPH Doug Krakower MD Aadia Rana MD |
| author_facet | Debbie L. Humphries PhD, MPH, MA Elizabeth C. Rhodes PhD, MS Christine L. Simon ScD, SM Victor Wang BA Donna Spiegelman ScD Corilyn Ott PhD David Hicks DO, MPH Julia L. Marcus PhD, MPH Doug Krakower MD Aadia Rana MD |
| author_sort | Debbie L. Humphries PhD, MPH, MA |
| collection | DOAJ |
| description | Pre-exposure prophylaxis (PrEP) is underused in the southern United States (US), a region with high HIV incidence. Clinical decision support (CDS) tools could increase PrEP prescriptions. We explored barriers to PrEP delivery and views of CDS tools to identify refinements for implementation strategies for PrEP prescribing and PrEP CDS tools. We conducted focus groups with health care providers from two federally qualified health centers in Alabama and analyzed the results using rapid qualitative methods. Barriers to PrEP included providers’ lack of training in PrEP, competing priorities and time constraints during clinical visits, concerns about side effects, and intensive workload. We identified refinements to the planned implementation strategies to address the barriers, including training all clinic staff in PrEP and having CDS PrEP alerts in electronic health records sent to all staff. Development and deployment of CDS tools in collaboration with providers has potential to increase PrEP prescribing in high-priority jurisdictions. |
| first_indexed | 2024-04-11T12:26:59Z |
| format | Article |
| id | doaj.art-7147b74fa294441e84e9c1f8e404b41d |
| institution | Directory Open Access Journal |
| issn | 2325-9582 |
| language | English |
| last_indexed | 2024-04-11T12:26:59Z |
| publishDate | 2022-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of the International Association of Providers of AIDS Care |
| spelling | doaj.art-7147b74fa294441e84e9c1f8e404b41d2022-12-22T04:23:54ZengSAGE PublishingJournal of the International Association of Providers of AIDS Care2325-95822022-12-012110.1177/23259582221144451Using Health Care Professionals’ Perspectives to Refine a Clinical Decision Support Implementation Strategy for Increasing the Prescribing of HIV Preexposure Prophylaxis (PrEP) in AlabamaDebbie L. Humphries PhD, MPH, MA0Elizabeth C. Rhodes PhD, MS1Christine L. Simon ScD, SM2Victor Wang BA3Donna Spiegelman ScD4Corilyn Ott PhD5David Hicks DO, MPH6Julia L. Marcus PhD, MPH7Doug Krakower MD8Aadia Rana MD9 Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, Connecticut, USA Department of Social and Behavioral Sciences, Yale School of Public Health, 135 College Street, New Haven, Connecticut, USA Department of Social and Behavioral Sciences, Yale School of Public Health, 135 College Street, New Haven, Connecticut, USA Department of Social and Behavioral Sciences, Yale School of Public Health, 135 College Street, New Haven, Connecticut, USA Department of Biostatistics, Yale School of Public Health, 135 College Street, New Haven, Connecticut, USA Family, Community, and Health Systems, University of Alabama-Birmingham School of Nursing, 1701 University Blvd, Birmingham, Alabama, USA Jefferson County Department of Public Health, Jefferson County Department of Health, 1400 sixth Ave. S, Birmingham, Alabama, USA Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Boston, Massachusetts, USA Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA Department of Infectious Diseases, University of Alabama-Birmingham Heersink School of Medicine, 1720 second Ave. S, Birmingham, Alabama, USAPre-exposure prophylaxis (PrEP) is underused in the southern United States (US), a region with high HIV incidence. Clinical decision support (CDS) tools could increase PrEP prescriptions. We explored barriers to PrEP delivery and views of CDS tools to identify refinements for implementation strategies for PrEP prescribing and PrEP CDS tools. We conducted focus groups with health care providers from two federally qualified health centers in Alabama and analyzed the results using rapid qualitative methods. Barriers to PrEP included providers’ lack of training in PrEP, competing priorities and time constraints during clinical visits, concerns about side effects, and intensive workload. We identified refinements to the planned implementation strategies to address the barriers, including training all clinic staff in PrEP and having CDS PrEP alerts in electronic health records sent to all staff. Development and deployment of CDS tools in collaboration with providers has potential to increase PrEP prescribing in high-priority jurisdictions.https://doi.org/10.1177/23259582221144451 |
| spellingShingle | Debbie L. Humphries PhD, MPH, MA Elizabeth C. Rhodes PhD, MS Christine L. Simon ScD, SM Victor Wang BA Donna Spiegelman ScD Corilyn Ott PhD David Hicks DO, MPH Julia L. Marcus PhD, MPH Doug Krakower MD Aadia Rana MD Using Health Care Professionals’ Perspectives to Refine a Clinical Decision Support Implementation Strategy for Increasing the Prescribing of HIV Preexposure Prophylaxis (PrEP) in Alabama Journal of the International Association of Providers of AIDS Care |
| title | Using Health Care Professionals’ Perspectives to Refine a Clinical Decision Support Implementation Strategy for Increasing the Prescribing of HIV Preexposure Prophylaxis (PrEP) in Alabama |
| title_full | Using Health Care Professionals’ Perspectives to Refine a Clinical Decision Support Implementation Strategy for Increasing the Prescribing of HIV Preexposure Prophylaxis (PrEP) in Alabama |
| title_fullStr | Using Health Care Professionals’ Perspectives to Refine a Clinical Decision Support Implementation Strategy for Increasing the Prescribing of HIV Preexposure Prophylaxis (PrEP) in Alabama |
| title_full_unstemmed | Using Health Care Professionals’ Perspectives to Refine a Clinical Decision Support Implementation Strategy for Increasing the Prescribing of HIV Preexposure Prophylaxis (PrEP) in Alabama |
| title_short | Using Health Care Professionals’ Perspectives to Refine a Clinical Decision Support Implementation Strategy for Increasing the Prescribing of HIV Preexposure Prophylaxis (PrEP) in Alabama |
| title_sort | using health care professionals perspectives to refine a clinical decision support implementation strategy for increasing the prescribing of hiv preexposure prophylaxis prep in alabama |
| url | https://doi.org/10.1177/23259582221144451 |
| work_keys_str_mv | AT debbielhumphriesphdmphma usinghealthcareprofessionalsperspectivestorefineaclinicaldecisionsupportimplementationstrategyforincreasingtheprescribingofhivpreexposureprophylaxisprepinalabama AT elizabethcrhodesphdms usinghealthcareprofessionalsperspectivestorefineaclinicaldecisionsupportimplementationstrategyforincreasingtheprescribingofhivpreexposureprophylaxisprepinalabama AT christinelsimonscdsm usinghealthcareprofessionalsperspectivestorefineaclinicaldecisionsupportimplementationstrategyforincreasingtheprescribingofhivpreexposureprophylaxisprepinalabama AT victorwangba usinghealthcareprofessionalsperspectivestorefineaclinicaldecisionsupportimplementationstrategyforincreasingtheprescribingofhivpreexposureprophylaxisprepinalabama AT donnaspiegelmanscd usinghealthcareprofessionalsperspectivestorefineaclinicaldecisionsupportimplementationstrategyforincreasingtheprescribingofhivpreexposureprophylaxisprepinalabama AT corilynottphd usinghealthcareprofessionalsperspectivestorefineaclinicaldecisionsupportimplementationstrategyforincreasingtheprescribingofhivpreexposureprophylaxisprepinalabama AT davidhicksdomph usinghealthcareprofessionalsperspectivestorefineaclinicaldecisionsupportimplementationstrategyforincreasingtheprescribingofhivpreexposureprophylaxisprepinalabama AT julialmarcusphdmph usinghealthcareprofessionalsperspectivestorefineaclinicaldecisionsupportimplementationstrategyforincreasingtheprescribingofhivpreexposureprophylaxisprepinalabama AT dougkrakowermd usinghealthcareprofessionalsperspectivestorefineaclinicaldecisionsupportimplementationstrategyforincreasingtheprescribingofhivpreexposureprophylaxisprepinalabama AT aadiaranamd usinghealthcareprofessionalsperspectivestorefineaclinicaldecisionsupportimplementationstrategyforincreasingtheprescribingofhivpreexposureprophylaxisprepinalabama |