2026 Eastern States Conference

Title: Evaluating the impact of pharmacist chart review intervention on the initiation of human immunodeficiency virus pre-exposure prophylaxis among high risk veterans
Authors: Allyson Sudduth, PharmD; Tanvi Patil, PharmD, BCPS, DPLA, MPH; James Martin, DO, FACOI; Christine Lanham, MSN, RN; Shikha Vasudeva, MD; Caitlin Swindall, PharmD, BCIDP
Objective: At the conclusion of my presentation, the participant will be able to describe the impact of pharmacist chart review intervention on the uptake of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP).
Self-Assessment Question: (True or false) Increasing PrEP prescriptions in high-risk patients can be fulfilled with chart intervention notes alone.
Background: Pre-exposure prophylaxis (PrEP) is highly effective at preventing human immunodeficiency virus (HIV), but is underutilized. This study aims to increase the proportion of at-risk veterans with an active PrEP prescription at a single facility.
Methods: This quality improvement study utilized the Veterans Health Administration’s national HIV PrEP dashboard to identify patients considered at risk for acquiring HIV by flagging those with a recent history of sexually transmitted infections, high risk sexual activity, or past antiretroviral prescription without a diagnosis of HIV. A pharmacist then placed a chart review note in the patients’ electronic medical records, tagging providers 1-2 weeks prior to their upcoming appointments to encourage discussion of PrEP therapy. The primary objective of this project was to describe the characteristics of patients identified by the HIV PrEP dashboard and assess the proportion of PrEP eligible patients who were initiated on PrEP therapy following pharmacist led intervention. Secondary objectives included the proportion of patients interested in PrEP following a discussion with their primary care provider and the proportion of patients initiated on PrEP following an infectious disease consult.
Results: A total of 41 patients were identified as eligible for PrEP therapy with confirmed ongoing risk of acquiring HIV. Five of the identified patients (12.2%) were men who had sex with men, thirty-six (87.8%) were flagged for high-risk sexual practices, and nine (22%) had a sexually transmitted infection in the last six months. Patients were followed for 30 days after their primary care appointment to evaluate discussion results. Ten patients have had their primary care appointment since the pharmacist intervention, and three patients (30%) have had an infectious disease consult ordered to initiate PrEP therapy. Three patients did not have a discussion of PrEP documented, three denied current sexual activity, and one declined PrEP.
Conclusion: The study results show that pharmacist chart interventions may increase PrEP utilization among high-risk patients. Ongoing interdisciplinary collaboration and communication is essential to improve HIV PrEP utilization. Providers will continue to be tagged in PrEP chart review notes on a rolling basis based on patient appointment dates to ensure timely interventions.