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Alyson Decker, NP, MPH San Francisco Department of Public Health California Project PrIDE Meeting November 16, 2016. What is academic detailing (AD)?. Provide unbiased, non-commercial, evidence-based information
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Alyson Decker, NP, MPH San Francisco Department of Public Health California Project PrIDE Meeting November 16, 2016
What is academic detailing (AD)? • Provide unbiased, non-commercial, evidence-based information • Follow a series of steps tailored to the clinician to encourage behavior change • Ends with getting a commitment to improve patient care National Resource Center for Academic Detailing (NaRCAD)
Key Messages • Take a thorough sexual history to identify patients who might benefit from PrEP. • Offer PrEP to patients identified as having risks for HIV. • Conduct an HIV test to confirm a patient is HIV negative before starting them on PrEP. • Follow-up with patients every 3 months for HIV/STD testing and 90-day PrEP refill.
Stressing importance of quarterly STD screening • Recommend q 3 month 3-site STD screening • Encouraging patient self-collection if time/costs are barriers to testing • “Starter kits”: 50 Aptima swabs • Self-collection rectal and pharyngeal swab posters
Patient Schwag ClinicianSchwag
After visit – Getting commitment • Use PrEP mnemonic • Offer PrEP when appropriate (PrEP Basics) • Create a plan for follow-up every 3 months (pocket card/brochure) • Screen patients for STIs with site-specific swabs (self-collection kit) • Give patient schwag for PrEP starts
Identifying providers • Serving priority populations • "Data to PreP” • Patient-identified • PleasePrEPMe.org & Greaterthan.org
Detailing experiences to date • 7 detailing visits • 67 evaluations collected • Many providers still not providing PrEP • Uncertainties around prescribing
Challenges • Getting time from providers • Clinic sessions or free time • Scheduling time without program assistance • Desire for group presentation • How to engage providers who don’t feel that their population would benefit • Improving sexual health care/STD testing in clinics