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TelePharm PrEP/PEP

2026年5月7日 更新者：Katrina Ortblad、Fred Hutchinson Cancer Center

Leveraging Telehealth to Optimize PrEP and PEP Delivery at Pharmacies in Kenya

In this study, the investigators will evaluate whether introducing a remote nurse to screen, counsel, and guide clients through HIV self-testing (via a telehealth platform) and support interested clients (via SMS) between pharmacy visits increases PrEP/PEP initiations and continuation compared to standard PrEP/PEP delivery by pharmacy providers. The investigators hypothesize that pharmacy PrEP/PEP services delivered with telehealth support will result in better service utilization and implementation outcomes compared to standard delivery and be cost-effective to implement.

調査の概要

状態

まだ募集していません

条件

介入・治療

詳細な説明

Participating study pharmacies will be 1:1 randomized 24 pharmacies (n=1,580 clients ≥15 years) to either: 1) telehealth support, where a remote nurse screens, counsels, and guides clients through HIV self-testing (HIVST) and, between visits, communicates with interested clients via 2-way SMS, or 2) standard delivery, where the pharmacy provider performs all delivery tasks and clients are not given additional support. The primary outcomes are PrEP/PEP initiation and continuation, assessed 180 days following clients' first pharmacy PrEP/PEP visit.

研究の種類

介入

入学 (推定)

1580

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

  • ケニア
      • Kisumu、ケニア
        • Kenya Medical Research Institute
        • コンタクト：
        • 主任研究者：
          • Elizabeth A Bukusi

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 子
  • 大人
  • 高齢者

健康ボランティアの受け入れ

はい

説明

Inclusion Criteria:

Pharmacies

  • Registered with the Pharmacy and Poisons Board (PPB)
  • Must have at least one full-time licensed pharmacist or pharmaceutical technologist on staff
  • Must have a private room where HIV testing and PrEP/PEP counseling can occur
  • >3 km from other study pharmacies
  • Willing to participate in research activities, including 2-day training for pharmacy providers
  • Willing to share pharmacy records with us
  • Sells HIVST kits that are WHO certified.

Pharmacists/remote nurses

  • ≥ 18 years old
  • Licensed pharmacist, pharmaceutical technologist, or nurse
  • Willing to provide PrEP and PEP services, including HIV testing and associated counseling services
  • Willing to complete training on PEP/PrEP service delivery at pharmacies, including certification for rapid diagnostic testing
  • Able and willing to provide informed consent

Clients

  • ≥ 15 years old
  • Interested in being screened for PrEP or PEP
  • Meets all criteria to be eligible for pharmacy-delivered PrEP or PEP on the Prescribing Checklist, including being at risk for HIV and not having any medical conditions that might contraindicate PrEP/PEP safety
  • Able and willing to provide informed consent

Exclusion Criteria:

Clients

  • Unwilling to provide a phone number at which an RA can reach them for completing surveys and communicate important study-related information
  • Currently enrolled in any other HIV vaccine or prevention trial
  • Have a condition that would preclude provision of informed consent, make study participation unsafe, complicate interpretation of outcome data, or otherwise interfere with achieving study objectives

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

  • 主な目的：防止
  • 割り当て：ランダム化
  • 介入モデル：並列代入
  • マスキング：なし（オープンラベル）

武器と介入

参加者グループ / アーム
介入・治療
実験的：Telehealth support
Pharmacy provider-led PrEP/PEP delivery, with telehealth support from remote nurses for counseling and testing at or between pharmacy visits (includes guided HIV self-testing and optional 2-way SMS with remote nurses).
他の：Telehealth delivery of pharmacy PrEP/PEP
Remote nurses screen, counsel, and guide HIV self-testing for pharmacy clients; pharmacy providers dispense PrEP or PEP. SMS support from remote nurses available between pharmacy visits.
アクティブコンパレータ：Standard delivery
Pharmacy provider-led PrEP/PEP delivery, without telehealth support from remote nurses for counseling and testing at or between pharmacy visits (includes guided HIV self-testing).
他の：Standard pharmacy PrEP/PEP delivery
Pharmacy provider screen, counsel, and guide HIV self-testing for pharmacy clients, and dispense PrEP or PEP. SMS support not available between pharmacy visits.

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
PrEP/PEP initiation
時間枠：18 months post implementation
Pharmacy-level; count outcome: # of unique clients dispensed any form of PrEP or PEP over the implementation period
18 months post implementation
PrEP/PEP continuation
時間枠：18 months post implementation
Pharmacy-level; count outcome: # of unique clients that refilled PrEP, transitioned from PEP-to-PrEP, or were dispensed PEP or on-demand PrEP 1+ times over the implementation period
18 months post implementation

二次結果の測定

結果測定
メジャーの説明
時間枠
PrEP initiation
時間枠：18 months post implementation
Pharmacy-level; count outcome: # of unique clients dispensed any form of PrEP over the implementation period
18 months post implementation
PEP initiation
時間枠：18 months post implementation
Pharmacy-level; count outcome: # unique clients dispensed any form of PEP over the implementation period
18 months post implementation
PrEP/PEP use
時間枠：1.5 and 6 months from initiation
Pharmacy-level; count outcome: # of unique clients who swallowed any PrEP or PEP during the implementation period
1.5 and 6 months from initiation
PrEP use
時間枠：1.5 and 6 months from initiation
Pharmacy-level; count outcome: # of unique clients who swallowed any PrEP during the implementation period
1.5 and 6 months from initiation
PEP use
時間枠：1.5 and 6 months from initiation
Pharmacy-level; count outcome: # of unique clients who swallowed any PEP during the implementation period
1.5 and 6 months from initiation
PrEP refill
時間枠：18 months post implementation
Pharmacy-level; count outcome: # of unique clients who refilled PrEP after initiating PrEP
18 months post implementation
Repeat PEP
時間枠：18 months post implementation
Pharmacy-level; count outcome: # unique clients who were dispensed PEP or PEP-in-pocket after initiating PEP
18 months post implementation
PEP-to-PrEP
時間枠：18 months post implementation
Pharmacy-level; count outcome: # unique clients who were dispensed PrEP after initiating PEP (any form) over the implementation period
18 months post implementation
Engaged with 1+ product
時間枠：18 months post implementation
Pharmacy-level; count outcome: # of unique clients that were dispensed more than one HIV prevention product (oral PrEP, injectable PrEP, PEP, etc) over the implementation period
18 months post implementation
On-demand PrEP use
時間枠：6 months from initiation
Pharmacy-level; count outcome: # of unique clients who were dispensed and swallowed any on-demand PrEP over the implementation period
6 months from initiation
PEP-in-Pocket use
時間枠：6 months from initiation
Pharmacy-level; count outcome: # of unique clients who were dispensed and swallowed any PEP-in-Pocket over the implementation period
6 months from initiation
Product choice
時間枠：18 months post implementation
Individual-level; binary outcome: % of total PrEP/PEP clients that were dispensed each type of product (e.g., oral PrEP, on- demand PrEP, PEP, DVR, etc).
18 months post implementation
PrEP adherence
時間枠：1.5 months from initiation
Individual-level; binary outcome: % PrEP initiators (excluding on-demand) with optimal TFV-DP concentration in DBS
1.5 months from initiation
Reach
時間枠：18 months post implementation
Individual-level; binary outcome: % of PrEP/PEP clients in different populations of interest (e.g., men; youth <25 years); with separate evaluations by product type
18 months post implementation
Efficiency
時間枠：18 months post implementation
Pharmacy-level; continuous outcome: Avg. duration (per visit & annually) of pharmacy providers' encounter per PrEP/PEP client, and clients' PrEP/PEP visit duration
18 months post implementation
Fidelity
時間枠：1.5 months post initiation
Individual-level; binary outcome: % of clients that received PrEP/PEP services as intended (e.g., correct quantity of drugs)
1.5 months post initiation
Sustainment
時間枠：24 months post implementation
Pharmacy-level; count outcome: Volume of unique PrEP/PEP clients served in the past 6 months, assessed at 24 months
24 months post implementation
Acceptability
時間枠：24 months post implementation
Individual-level; cont, binary outcome: # of unique client who find the study components acceptable; % of providers, including remote nurses, indicating acceptability; Also assessed in Aim 2 (described below)
24 months post implementation

その他の成果指標

結果測定
メジャーの説明
時間枠
Time to use (for on-demand PrEP) at 1.5 months
時間枠：1.5 months
Pharmacy-level; continuous outcome: Avg. duration (in days) from on-demand PrEP dispensing to use, among on-demand clients
1.5 months
Time to use (for on-demand PrEP) at 6 months
時間枠：6 months
Pharmacy-level; continuous outcome: Avg. duration (in days) from on-demand PrEP dispensing to use, among on-demand clients
6 months
STI diagnosis
時間枠：18 months post implementation
Individual-level; binary outcome: % of PrEP/PEP clients with a syndromic STI diagnosis (at any pharmacy PrEP/PEP visit)
18 months post implementation
Other drugs dispensed
時間枠：18 months post implementation
Pharmacy-level; binary outcome: % of PrEP/PEP clients dispensed other drugs (e.g., hypertension, contraception) at their visit
18 months post implementation
HIV incidence
時間枠：18 months
Pharmacy-level; binary outcome: % of PrEP/PEP clients who tested positive
18 months
HIV risk
時間枠：18 months post implementation
Inidiviudal-level; binary outcome: % of PrEP/PEP clients reporting specific behaviors (i.e., multiple sex partners)
18 months post implementation

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

Fred Hutchinson Cancer Center

協力者

National Institute of Mental Health (NIMH)
Kenya Medical Research Institute
ClickMedix LLC

捜査官

  • スタディチェア：Kendall V Harkey、Fred Hutch Cancer Center
  • スタディチェア：Rachel C Malen、Fred Hutch Cancer Center
  • 主任研究者：Katrina F Ortblad、Fred Hutch Cancer Center

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年10月1日

一次修了 (推定)

2028年3月31日

研究の完了 (推定)

2028年9月30日

試験登録日

最初に提出

2026年4月24日

QC基準を満たした最初の提出物

2026年4月24日

最初の投稿 (実際)

2026年5月1日

学習記録の更新

投稿された最後の更新 (実際)

2026年5月11日

QC基準を満たした最後の更新が送信されました

2026年5月7日

最終確認日

2026年5月1日

詳しくは

本研究に関する用語

キーワード

その他の研究ID番号

  • RG1125680
  • R01MH140465 (米国 NIH グラント/契約)

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

Participant-level pharmacy record and research data will be shared through deposition of the data in an open-access public repository (Dryad). In addition to sharing the study data publicly, data dictionaries and other tools supporting use of the data will be shared.

IPD 共有時間枠

De-identified pharmacy record and research data from this study will be deposited in the Dryad data repository within 12 months of publication.

IPD 共有アクセス基準

The study data will be accessible through the Dryad data repository. For all publications, a dataset will be created that is assigned a digital object identifier (DOI), which will be referenced in the publication so the research community can easily find and access the data, if interested. The Dryad repository can also be searched by topic, institution, and investigator name, which should make it easy for other interested parties to find and access the study data.

Any study data that cannot be shared via Dryad, will be made available through a formal request to the PIs. We will share data and supporting documentation upon request to outside investigators, after scientific review, IRB approval, and obtaining relevant Data Use Agreements.

IPD 共有サポート情報タイプ

  • STUDY_PROTOCOL
  • SAP
  • ICF

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

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