Empowering Tennessee Pharmacists to Initiate PrEP Using Collaborative Pharmacy Practice Agreements
2.1. Study Design
2.2. Participants and Recruitment
2.3. Data Analysis
3.1. Learning from other States and Previous Successful Collaborative Pharmacy Practice Agreements to Advance and Expand Innovative Models of Patient Care
“…I have read extensively the CPPAs that currently exist. The Oregon model is probably one of the most fascinating to me, having a phlebotomist on staff, and the pharmacy is mainly a PrEP-dispensing clinic. They do other work as well as far as providing pharmaceutical services.”(P10, FG10)
“…I’m just wondering how we would go about that part because PrEP patients have to be tested every three months once they’re started. I think if we were able to do that initial, you know, we have a patient that comes in that’s interested in it, if we can do the initial, let me write you a prescription for this and get them started with the notion that they have to follow up with a clinic to get lab work done, you know, I think that as far as initiating PrEP. I think that that should be shown with the metrics that we have with our metrics to patients, if there was some way that we could show legislation that that’s what we can do, I think it would benefit so many people.”(P12, FG3)
“…So I would guess that a big reason that naloxone has been leaned into so much has been because the financial burden of this has been really obvious to everyone, but I’m not so sure that the financial burden of the HIV epidemic is so obvious in this state, so maybe if that were highlighted to legislators more, then they would be more inclined to promote the PrEP or start initiatives for that.”(P21, FG4)
“…just thinking about once we are able to kind of identify that patient population, having strategically placed CPAs, where pharmacists who can have a focus or want to have a focus in improving PrEP intake and uptake can actually take action after that conversation occurs and take that next step with that patient. So that’s kind of where I see the benefit.”(P2, FG2)
“I think a CPA would just expand access, because, you know, doctors might be super busy, booked up, maybe you can’t get in until-booking three months out or something. Where, versus, the pharmacist running it through CPA, it would just be quicker and more access, easier to get that visit.”(P3, FG1)
3.2. Advocacy through Public Policy Change to Empower Pharmacists to Initiate PrEP
“…I think for something like that to happen in Tennessee, you would have to have- going back to grass roots-petitions, backing by Tennessee Pharmacist Association [TPA], but also pharmacists, corporations who would be on board to go to board meetings and educate the board and give them examples, here’s what happens in California, this is something that we need to be doing here.”(P1, FG1)
“And speaking of barriers, Tennessee, I mean… we all know what the rules are in our state, like it’s extremely burdensome to have a collaborative practice agreement. So I think that that’s a huge barrier.”(P2, FG1)
“…I think we need to focus on lobbying legislators to show them like our statistics, our metrics, how many HIV patients do we serve, show them the Medication Therapy Management [MTMs] that we’re doing and how pharmacist interventions have changed their medications and improved compliance … and to keep them out of the hospital. If we show them with facts and statistics, that will be one of our main things to say, hey, we should be able to prescribe PrEP, and it’s going to be beneficial financially and health wise.”(P15, FG3)
“…I think our local organizations, and then in concert with the Board of Pharmacy, like I think that we have to have both of those stakeholders onboard to really be advocating for us in politics and in state legislation with the medical board.”(P4, FG1)
”… Just like right now in Tennessee how we have the prescriptive authority for standing orders for like flu vaccines and other such vaccines, maybe giving us some authority as clinical practitioners to be able to prescribe PrEP.”(P6, FG2)
“…It’s definitely multifactorial. The first being that, yes, in Tennessee, we have Collaborative Practice Agreements for prevention methods, so we could collaborate with a provider that’s going to take a lot on the individual pharmacist or particular company in order to pursue those. So some of the corporate legal barriers that exist there.”(P10, FG2)
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Gender||Race||Ethnicity||Practice Site||Years in Practice|
|Not provided||Indian||Non-Hispanic||Community Pharmacy||21|
|M||African American||Non-Hispanic||Community Pharmacy||6|
|M||African American||Non-Hispanic||Community Pharmacy||14|
|M||African American||Non-Hispanic||Community Pharmacy||45|
|F||African American||Non-Hispanic||Community Pharmacy||3|
|F||African American||Non-Hispanic||Community Pharmacy||4|
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Cernasev, A.; Barenie, R.E.; Wofford, B.R.; Golden, J.; Walker, C. Empowering Tennessee Pharmacists to Initiate PrEP Using Collaborative Pharmacy Practice Agreements. Clin. Pract. 2023, 13, 280-287. https://doi.org/10.3390/clinpract13010025
Cernasev A, Barenie RE, Wofford BR, Golden J, Walker C. Empowering Tennessee Pharmacists to Initiate PrEP Using Collaborative Pharmacy Practice Agreements. Clinics and Practice. 2023; 13(1):280-287. https://doi.org/10.3390/clinpract13010025Chicago/Turabian Style
Cernasev, Alina, Rachel E. Barenie, Breanne R. Wofford, Jay Golden, and Crystal Walker. 2023. "Empowering Tennessee Pharmacists to Initiate PrEP Using Collaborative Pharmacy Practice Agreements" Clinics and Practice 13, no. 1: 280-287. https://doi.org/10.3390/clinpract13010025