Expanding expedited partner therapy and HIV prophylaxis in the emergency department

Author:

Mercer Kevin J1ORCID,Brizzi Marisa B2ORCID,Burhoe Devon N3ORCID,Senn Joshua M4,Rohani Roxane5ORCID,Nowicki Diana Nicole6ORCID,Januszka Jenna E7ORCID,Wordlaw Rudijah8,Durham Spencer H9ORCID

Affiliation:

1. University of Texas at Austin College of Pharmacy, Austin, TX, and Department of Pharmacy, Houston Methodist West Hospital , Katy, TX , USA

2. Department of Pharmacy, University of Cincinnati Health , Cincinnati, OH , USA

3. Department of Pharmacy, St. Joseph’s/Candler Health System , Savannah, GA , USA

4. Department of Pharmacy, UofL Health – UofL Hospital, Louisville, KY, and Department of Emergency Medicine, University of Louisville School of Medicine , Louisville, KY , USA

5. Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, and Captain James A. Lovell Federal Health Care Center , North Chicago, IL , USA

6. UNC Health, Chapel Hill, NC, and UNC Eshelman School of Pharmacy , Chapel Hill, NC , USA

7. University of Illinois Chicago College of Pharmacy , Chicago, IL , USA

8. John H. Stroger, Jr. Hospital of Cook County , Chicago, IL , USA

9. Auburn University Harrison College of Pharmacy , Auburn, AL , USA

Abstract

Abstract Purpose Sexually transmitted infections (STIs) continue to have a disproportionate impact on individuals belonging to sexual, gender, and racial minorities. Across the nation, many emergency medicine pharmacists (EMPs) possess the skills and knowledge to expand the provision of expedited partner therapy (EPT) for STIs and provide HIV prophylaxis within existing practice frameworks. This report serves as a call to action for expanded provision of EPT and HIV prophylaxis by EMPs and highlights current barriers and solutions to increase pharmacist involvement in these practice areas. Summary Emergency medicine pharmacy practice continues to expand to allow for limited prescribing authority through collaborative practice agreements (CPAs). In recent years, CPA restrictions have been changed to facilitate treatment of more patients with less bureaucracy. This report addresses the unique challenges and opportunities for expanding EPT and HIV pre- and postexposure prophylaxis provision by pharmacists in emergency departments (EDs). Furthermore, current strategies and treatments for EPT, such as patient-delivered partner therapy and HIV prophylaxis, are discussed. Pharmacist involvement in STI treatment and HIV prevention is a key strategy to increase access to high-risk populations with high ED utilization and help close current gaps in care. Conclusion Expanding EMP provision of EPT and HIV prophylaxis may be beneficial to reducing the incidence of STIs and HIV infection in the community. CPAs offer a feasible solution to increase pharmacist involvement in the provision of these treatments. Legislative efforts to expand pharmacist scope of practice can also contribute to increasing access to EPT and HIV prophylaxis. With these efforts, EMPs can play an essential role in the fight against STIs and HIV.

Publisher

Oxford University Press (OUP)

Subject

Health Policy,Pharmacology

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