The Role of a Specialist HIV Pre-Exposure Prophylaxis Pharmacist

IntroductionThe efficacy of HIV Pre-Exposure Prophylaxis (PrEP) is well established, however success largely depends on reach, access and medication adherence. This review describes the expanding role of a pharmacist within a sexual and reproductive health (SRH) clinic including the benefits of improved quality of care and access to PrEP.MethodData was collected on successful service improvements implemented by a specialist HIV PrEP pharmacist.ResultsSince being in post from July 2022 the pharmacist alongside members of the MDT has led on the following service improvements:- • Implementation of a streamlined all-day nurse led clinic for routine PrEP through patient group directive sign offs and education and training. This has led to an increase in uptake of PrEP by 30%. • Establishing a weekly virtual complex PrEP MDT clinic to review medical complexities such as side effects and renal impairment. This has allowed us to provide options and nephrology referrals for patients who cannot take NHS PrEP. Over 500 patients which is over 20% of our cohort has been reviewed over a 6-month period. • Creation of an online appointment system for PrEP appointments. • Implementation of a weekly Pharmacist PrEP clinic for training new staff and reviewing complex patients (up to 5 patients/week). • Strategic planning for novel deliveries of PrEP to increase capacity and access for marginalised communities (e.g. via medication lockers and remote pathways).DiscussionPharmacists are experts in medication, adherence counselling, adverse effects and monitoring which are critical to clinically successful and safe PrEP usage. PrEP service leadership by a pharmacist skilled in HIV/SRH with an understanding of contracts and supply chain has proven to be beneficial. Together with other clinicians, pharmacists should be directly involved in driving PrEP service development to improve access, reach and lead complex MDTs.