Those living with HIV/AIDS present unique challenges, risks and opportunities across the spectrum of care – from PrEP (pre-exposure) to HIV (HIV diagnosis) to PEP (post-exposure) – which require proven solutions to support patient health and maximize clinician performance.
We built the TherigySTM HIV suite of care plans because we know that clinicians are facing unnecessary barriers, including insufficient and illegible dosing information, meaningless medication table warnings and precautions, and no clear delineation between PrEP/PEP and HIV to support outcome reporting.
The TherigySTM HIV care plans allow clinicians to streamline their patient therapy management process to record PrEP, PEP, and HIV patient data efficiently and effectively. The system improves results clinically, financially, and operationally throughout the patient journey and helps remove the stigma patients often face in the pre-and post-HIV stages.
How do TherigySTM HIV Patient Care Plans help clinicians manage and monitor HIV patients?
TherigySTM’s streamlined HIV assessment is an all-inclusive platform that contains three distinct care plans – PrEP, HIV, and PEP. Let’s review the details of each care plan starting with pre-exposure phase, then review the diagnosis stage, all the way through post-exposure.
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PrEP Care Plan
TherigySTM’s PrEP care plan is housed within the HIV therapeutic category.
The plan is designed to see the whole patient, including the patient’s need for PrEP and barriers to adherence such as lifestyle choices and a lack of support structure at home.
The PrEP care plan captures the following outcomes to measure success:
- Total number of patients in PrEP, HIV, and PEP
- Number of PrEP patients in the program and how long they are in the program
- HIV status documentation at each clinical call
- Side effects that may lead to poor adherence
The patient’s goal is to remain HIV negative, which is fully supported by these program outcomes. The PrEP care plan takes it a step further to make sure that symptoms of acute retroviral syndrome are assessed on follow-up calls and the need for retesting is offered and captured.
The care plan itself allows the clinician to select an indication for PrEP in order to:
- Help run patient demographics, which could lead to gathering resources that better suit the patient’s needs
- Tailor the conversation by using the proper pronouns and knowing the patient’s home life, how they identify, and safer sex practices
HIV Care Plan
The HIV care plan is designed with most patients’ three primary goals in mind: (1) become undetectable as soon as possible; (2) prevent the spread of HIV; and (3) experience the least number of side effects.
To help clinicians navigate the complexities of medication protocols, the HIV care plan delves into details (instead of broad generalities), highlighting specific precautions for each drug as it is applicable for each individual patient.
Each HIV care plan is built to achieve:
- A downward trend in viral load with the ultimate goal of viral suppression
- An increase in CD4 count year over year until a steady state is reached
- A reduction in toxicities associated with anti-retroviral medications by using helpful teaching points on side effect management
PEP Care Plan
PEP therapy is unique because the medication is dispensed once and then the patient either remains negative or has now contracted HIV and needs to be managed differently.
With our PEP care plan, clinicians can track the source patient and the exposed patient within the same assessment and report whether patient received their prescription and medication within 72 hours of exposure. Clinicians can also follow up early to either check for side effects and continue treatment, or to discontinue treatment early if there is a negative result from the source patient.
The PEP care plan allows the clinician to:
- Track full courses of treatment (28-day regimens) or detail patients who end therapy early if the source patient tests negative and patient reports no risky behavior over the course of 6 weeks
- Identify occupational and non-occupational exposures
- Recognize patients who remain negative or those who transition into the HIV module
- Assess the exposed patient's HIV status 3 to 6 months after exposure to ensure patient is still HIV negative
Information regarding the source and exposed patient closely aligns with CDC and Canadian guidelines regarding how to manage PEP patients, which can help guide care and understand reasons behind a delay in receiving their PEP regimen outside of 72 hours. Clinicians may follow up with the patients early to assess for side effects and assess for hepatitis B and C, acute retroviral syndrome, and take action accordingly.
Conclusion
TherigySTM’s HIV clinical care plans help clinicians gather essential information to help manage HIV, PrEP, and PEP patients and work towards better outcomes and enhanced efficiency for the pharmacy.
To learn more about the HIV clinical care plans and the capabilities of TherigySTM, contact us for more information.
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MORE ABOUT HIV/AIDS
What is HIV?
HIV is caused by a virus that can spread through sexual contact or blood, or from mother to child during pregnancy, childbirth, or breast-feeding. HIV destroys CD4 T cells – the white blood cells that play a large role in helping the body fight disease. The fewer CD4 T cells, the weaker the immune system becomes. Untreated, HIV typically turns into Acquired Immune Deficiency Syndrome (AIDS) within about 8 to 10 years. Thanks to better antiviral treatments, most people diagnosed with HIV today in the United States do not develop AIDS. (Source: https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524)
How many people are affected by HIV?
Approximately 1.2 million people in the U.S. are living with HIV today. About 14 percent of them are unaware and need testing. HIV continues to have a disproportionate impact on certain populations, particularly racial and ethnic minorities, and gay and bisexual men.
An estimated 36,400 new HIV infections occurred in the United States in 2018.
- In 2018, 37,968 people received an HIV diagnosis in the U.S. and 6 dependent areas—an overall 7% decrease compared with 2014.
- HIV diagnoses are not evenly distributed across states and regions. The highest rates of new diagnoses continue to occur in the South.
(Source: https://www.cdc.gov/hiv/statistics/overview/index.html)