PRP063: Preliminary results of HIV PrEP Order Set Implementation and Evaluation of Provider Knowledge and Prescription Habits
Rensa Chen, DO; Jared Roberts; Jessica Parascando; Jarrett Sell, MD, FAAFP, AAHIVS
Abstract
Context: There is a lack of provider knowledge, prescription and education of Pre-exposure prophylaxis (“PrEP”), a combination of medications designed to prevent human immunodeficiency virus (HIV) infection in high-risk populations. Currently, Penn State College of Medicine (PSCOM) has a standard set of labs required to start a patient on PrEP. However, educational outreach and a lab order set providing a checklist of labs for providers when prescribing PrEP may facilitate barriers to prescribing PrEP, such as lack of resources, comfort and personal beliefs about HIV prevention. Objective: To improve HIV prevention care to patients through provider education of PrEP (educational talks, pamphlets), implementation of a PrEP order set, and pre- and post-implementation assessment of provider PrEP knowledge and prescription habits. Study Design and Analysis: Pre/post survey study. Setting: Medical providers at PSCOM. Population: Providers in the departments of Family and Community Medicine and Internal Medicine at PSCOM (n=279). Instrument: REDCap survey includes Likert scale questions adapted from PCP PrEP Survey (Balckstock et al. 2016) assessing provider knowledge, comfort, and prescription habits of PrEP. Outcome Measures: Provider knowledge, comfort, and prescription habits of PrEP. Results: 133 providers completed the pre-survey (47.7% response rate; mean age 37.9 years; 52.6% Female). Over 50% of providers reported “Very Good” or “Excellent” overall knowledge of HIV PrEP, but were less confident in their knowledge of lab testing. Those more recently medically trained had higher levels of comfort and significantly higher levels of knowledge with PrEP utilization (p=.001). While providers most highly rated training/education as a barrier, an EMR order set was rated most highly for facilitating PrEP prescribing. Providers 5-10 years after training perceived the greatest knowledge, while providers more than 20 years outside of their training had the greatest perceived comfort with PrEP usage. Non-PrEP prescribers perceived more barriers and less facilitators, and responses from this group suggest the most effective way to increase PrEP usage was the utilization of a lab order set integrated into the EMR. Expected Outcomes: We anticipate that post-intervention providers will self-report an increase in PrEP knowledge, comfort and prescribing of PrEP. We anticipate non-PrEP prescribers to show the greatest increase in knowledge, comfort, and PrEP utilization.