Expanding HIV Prevention in Colorado—and Nationwide

This activity fulfills Colorado State Board of Pharmacy training requirements under Colorado State House Bill 20-1061 (CO HB20-1061). Participants who successfully complete this activity will receive a certificate confirming they have fulfilled the requirements laid out by the Colorado State Board of Pharmacy under CO HB20-1061.

Faculty

Primary Author
Dan Scales, Pharm D, AAHIVP
Director of Pharmacy Collaborative Care
Vivent Health
Denver, Colorado

Reviewer
Emily Zadvorny, PharmD, BCPS
Executive Director, Colorado Pharmacists Society
Clinical Associate Professor
University of Colorado Skaggs School of Pharmacy
Denver, Colorado

Target Audience

This activity is intended for clinical and community pharmacists involved in the care of patients at risk for human immunodeficiency virus (HIV) infection.

Learning Objectives

After completing this activity, the participant should be better able to:

• Assess patients’ risk of HIV acquisition based on the type of exposure
• Determine patients’ preexposure prophylaxis (PrEP) eligibility through HIV testing, sexual history-taking, and appropriate laboratory testing
• Implement guideline-driven postexposure prophylaxis (PEP)- and PrEP-prescribing principles with regard to treatment initiation and monitoring
• Select appropriate antiretroviral regimens for PEP or PrEP to prevent HIV infection
• Apply rules from the Colorado State Board of Pharmacy for pharmacist-prescribed and dispensed PrEP and PEP regimens

Program Description

This in-depth electronic monograph for pharmacists provides guideline-based clinical information and resources to support those whose scope of practice now allows for direct provision of HIV preexposure and postexposure prophylaxis (PrEP and PEP). This “301”-level activity specifically supports the needs of Colorado pharmacists now challenged to come up to speed on PEP/PrEP guidelines as they relate to their expanded scope of practice under Colorado State House Bill (HB) 20-1061 and the Colorado State Board of Pharmacy Statewide Protocols (Rule 17, Appendix C). It also offers a synthesis of best practices and real-world considerations and serves as a model for expansion and optimization of PEP/PrEP care across pharmacy practice nationwide. This activity will provide Colorado pharmacists with clinical information for initiating and monitoring PrEP and PEP treatment in a pharmacy setting. In addition, the activity discusses policy updates and includes all content necessary to fulfill the training requirements, as determined by the Colorado Board of Pharmacy Licensing Committee, for pharmacists wishing to become PrEP and PEP providers, such as:

• HIV epidemiology and burden of disease
• Pharmacology of HIV medications used for PEP and PrEP as well as their efficacy and safety
• Pretreatment determination of PrEP/PEP eligibility: eligibility criteria, screening, and labs
• Assessment of sexual health and HIV risk
• Patient-centered medication selection: assessing advantages and disadvantages of approved medications for individual patients
• Monitoring considerations and potential adverse events
• Patient counseling and adherence
• Testing for HIV and sexually transmitted infections (STIs)
• Helping the patient navigate beyond pharmacy-based care: referral, advocacy, and resources
• In-pharmacy PEP/PrEP implementation
• Resources for pharmacists

Although the focus of this activity will be the Colorado scope of practice, it may also inform pharmacists nationwide of evolving practice protocols, so they may be prepared—and advocate—for future opportunities in their areas.

The monograph also contains an electronic Q&A Forum in which learners can pose questions to the program faculty as they prepare to implement PEP and PrEP services in their pharmacy practices.

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine (PIM) and Integritas Communications. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the health care team.

Continuing Pharmacy Education

PIM designates this continuing education activity for 2.0 contact hours (0.2 CEUs) of the Accreditation Council for Pharmacy Education. (Universal Activity Number – JA4008162-9999-21-2557-H01-P)

This is a knowledge-based activity.

Disclosure of Conflicts of Interest

PIM requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflicts of interest (COIs) they may have as related to the content of this activity. All identified COIs are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality activities and related materials that promote improvements or quality in health care and not a specific proprietary business interest of a commercial interest.

Dan Scales, Pharm D, AAHIVP:   Nothing to disclose

Emily Zadvorny, PharmD, BCPS: Nothing to disclose

Planners and Managers

The PIM planners and managers have nothing to disclose. The Integritas Communications planners and managers have nothing to disclose.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

Instructions to Receive Credit

To receive credit for this activity, participants must complete the preactivity questionnaire, complete and receive a minimum score of 70% on the posttest, and complete the program evaluation.

Colorado State Board of Pharmacy Training Requirements

This activity fulfills Colorado State Board of Pharmacy training requirements under CO HB20-1061. This legislation stipulates that you are responsible for retaining a record of completing this training for at least 3 years from the date of completion. In order to prescribe PrEP and provide ongoing management of these patients you must also:  1) hold a current license to practice in Colorado; 2) be engaged in the practice of pharmacy; 3) have a PharmD degree or at least 5 years of experience as a licensed pharmacist; and 4) carry adequate liability insurance (at least $1,000,000 per incident and at least $3,000,000 in aggregate). If you need more information about liability insurance, go to https://www.copharm.org/professional-liability-insurance.

Fee Information & Refund/Cancellation Policy

There is no fee for this educational activity.

Clinical Resource Center

For a list of online clinical resources, please visit www.ExchangeCME.com/PrEPResourcesforCOPharms.

CPE Questions – PIM Contact Information

For information about the accreditation of this program, please contact PIM via email at inquiries@pimed.com or at http://www.pimed.com/.

Integritas Contact Information

For all other questions regarding this monograph, please contact Integritas via email at info@exchangecme.com.

Developed in collaboration with the American Academy of HIV Medicine and the Colorado Pharmacists Society.