Adaptation of POCT for pharmacies to reduce risk and optimize access to care in HIV, the APPROACH study protocol: examining acceptability and feasibility
Abstract Background Approximately 1 in 5 Canadians with HIV are unaware of their status. In many provinces and especially rural communities, barriers to HIV testing include lack of access, privacy concerns, and stigma. The availability of HIV point-of-care testing (POCT) is limited across Canada. Ph...
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| Format: | Article |
| Language: | English |
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BMC
2018-02-01
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| Series: | Pilot and Feasibility Studies |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40814-018-0252-1 |
| _version_ | 1818032110437400576 |
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| author | Jason Kielly Deborah V. Kelly Christine Hughes Kristine Day Stephanie Hancock Shabnam Asghari Jacqueline Gahagan Carlo Marra Hai Nguyen |
| author_facet | Jason Kielly Deborah V. Kelly Christine Hughes Kristine Day Stephanie Hancock Shabnam Asghari Jacqueline Gahagan Carlo Marra Hai Nguyen |
| author_sort | Jason Kielly |
| collection | DOAJ |
| description | Abstract Background Approximately 1 in 5 Canadians with HIV are unaware of their status. In many provinces and especially rural communities, barriers to HIV testing include lack of access, privacy concerns, and stigma. The availability of HIV point-of-care testing (POCT) is limited across Canada. Pharmacists are well positioned to address barriers by offering rapid HIV POCT and facilitating linkage to care. Methods We will use a type-2 hybrid implementation-effectiveness design to assess a pilot HIV POCT model in one urban and one rural pharmacy in each of two Canadian provinces over 6 months. In this feasibility trial the research aims include developing and assisting pharmacies in implementing the model, evaluating processes/determinants of program implementation, evaluating the model’s effects on client outcomes, preferences, and testing satisfaction. Using a community-based research approach, the research team will engage community stakeholders in each province including individuals with lived experience to inform the development of the pharmacy-based HIV testing model and support the research team throughout the study. A multipronged promotion campaign will be used to promote the study and facilitate recruitment. The pharmacy-based testing model will include pre/post-test counseling and linkage to care plans in addition to pharmacist-administered HIV POCT. Pharmacists will complete a comprehensive training program prior to implementing the testing model. Client demographics and satisfaction will be assessed by surveys and interviews. Pharmacists will document time required for testing and participate in a post-study focus group to discuss barriers/enablers. Implementation will be assessed qualitatively and quantitatively. The process of developing and implementing the model will be described using qualitative data and a logic model. Acceptability and barriers/enablers will be examined qualitatively based on survey responses. A preliminary costing assessment will consider the client, pharmacy, and government perspectives. Discussion The results of this pilot will inform modifications to the HIV POCT model to optimize effectiveness and increase scalability. The study has national importance, providing valuable information on improving access to HIV testing. Future applications of this research may expand the role of pharmacists in offering POCT for other sexually transmitted/bloodborne infections as tests become available in Canada. Trial registration Clinicaltrials.gov, NCT03210701 |
| first_indexed | 2024-12-10T06:02:10Z |
| format | Article |
| id | doaj.art-b8a621732d9a4feb96d3838e2a6f099b |
| institution | Directory Open Access Journal |
| issn | 2055-5784 |
| language | English |
| last_indexed | 2024-12-10T06:02:10Z |
| publishDate | 2018-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Pilot and Feasibility Studies |
| spelling | doaj.art-b8a621732d9a4feb96d3838e2a6f099b2022-12-22T01:59:48ZengBMCPilot and Feasibility Studies2055-57842018-02-014111010.1186/s40814-018-0252-1Adaptation of POCT for pharmacies to reduce risk and optimize access to care in HIV, the APPROACH study protocol: examining acceptability and feasibilityJason Kielly0Deborah V. Kelly1Christine Hughes2Kristine Day3Stephanie Hancock4Shabnam Asghari5Jacqueline Gahagan6Carlo Marra7Hai Nguyen8School of Pharmacy, Memorial University of NewfoundlandSchool of Pharmacy, Memorial University of NewfoundlandFaculty of Pharmacy and Pharmaceutical Sciences, University of AlbertaSchool of Pharmacy, Memorial University of NewfoundlandSchool of Pharmacy, Memorial University of NewfoundlandFaculty of Medicine, Memorial UniversitySchool of Health and Human Performance, Dalhousie UniversitySchool of Pharmacy, University of OtagoSchool of Pharmacy, Memorial University of NewfoundlandAbstract Background Approximately 1 in 5 Canadians with HIV are unaware of their status. In many provinces and especially rural communities, barriers to HIV testing include lack of access, privacy concerns, and stigma. The availability of HIV point-of-care testing (POCT) is limited across Canada. Pharmacists are well positioned to address barriers by offering rapid HIV POCT and facilitating linkage to care. Methods We will use a type-2 hybrid implementation-effectiveness design to assess a pilot HIV POCT model in one urban and one rural pharmacy in each of two Canadian provinces over 6 months. In this feasibility trial the research aims include developing and assisting pharmacies in implementing the model, evaluating processes/determinants of program implementation, evaluating the model’s effects on client outcomes, preferences, and testing satisfaction. Using a community-based research approach, the research team will engage community stakeholders in each province including individuals with lived experience to inform the development of the pharmacy-based HIV testing model and support the research team throughout the study. A multipronged promotion campaign will be used to promote the study and facilitate recruitment. The pharmacy-based testing model will include pre/post-test counseling and linkage to care plans in addition to pharmacist-administered HIV POCT. Pharmacists will complete a comprehensive training program prior to implementing the testing model. Client demographics and satisfaction will be assessed by surveys and interviews. Pharmacists will document time required for testing and participate in a post-study focus group to discuss barriers/enablers. Implementation will be assessed qualitatively and quantitatively. The process of developing and implementing the model will be described using qualitative data and a logic model. Acceptability and barriers/enablers will be examined qualitatively based on survey responses. A preliminary costing assessment will consider the client, pharmacy, and government perspectives. Discussion The results of this pilot will inform modifications to the HIV POCT model to optimize effectiveness and increase scalability. The study has national importance, providing valuable information on improving access to HIV testing. Future applications of this research may expand the role of pharmacists in offering POCT for other sexually transmitted/bloodborne infections as tests become available in Canada. Trial registration Clinicaltrials.gov, NCT03210701http://link.springer.com/article/10.1186/s40814-018-0252-1HIVPharmacyPharmacistPoint of care testRapid HIV testImplementation science |
| spellingShingle | Jason Kielly Deborah V. Kelly Christine Hughes Kristine Day Stephanie Hancock Shabnam Asghari Jacqueline Gahagan Carlo Marra Hai Nguyen Adaptation of POCT for pharmacies to reduce risk and optimize access to care in HIV, the APPROACH study protocol: examining acceptability and feasibility Pilot and Feasibility Studies HIV Pharmacy Pharmacist Point of care test Rapid HIV test Implementation science |
| title | Adaptation of POCT for pharmacies to reduce risk and optimize access to care in HIV, the APPROACH study protocol: examining acceptability and feasibility |
| title_full | Adaptation of POCT for pharmacies to reduce risk and optimize access to care in HIV, the APPROACH study protocol: examining acceptability and feasibility |
| title_fullStr | Adaptation of POCT for pharmacies to reduce risk and optimize access to care in HIV, the APPROACH study protocol: examining acceptability and feasibility |
| title_full_unstemmed | Adaptation of POCT for pharmacies to reduce risk and optimize access to care in HIV, the APPROACH study protocol: examining acceptability and feasibility |
| title_short | Adaptation of POCT for pharmacies to reduce risk and optimize access to care in HIV, the APPROACH study protocol: examining acceptability and feasibility |
| title_sort | adaptation of poct for pharmacies to reduce risk and optimize access to care in hiv the approach study protocol examining acceptability and feasibility |
| topic | HIV Pharmacy Pharmacist Point of care test Rapid HIV test Implementation science |
| url | http://link.springer.com/article/10.1186/s40814-018-0252-1 |
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