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TelePharm PrEP/PEP

7 de maio de 2026 atualizado por: 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.

Visão geral do estudo

Status

Ainda não está recrutando

Condições

Intervenção / Tratamento

Descrição detalhada

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.

Tipo de estudo

Intervencional

Inscrição (Estimado)

1580

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Locais de estudo

  • Quênia
      • Kisumu, Quênia
        • Kenya Medical Research Institute
        • Contato:
        • Investigador principal:
          • Elizabeth A Bukusi

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Filho
  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Sim

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Prevenção
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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).
Outro: 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.
Comparador Ativo: 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).
Outro: 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.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
PrEP/PEP initiation
Prazo: 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
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
PrEP initiation
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 18 months post implementation
Pharmacy-level; count outcome: # of unique clients who refilled PrEP after initiating PrEP
18 months post implementation
Repeat PEP
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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

Outras medidas de resultado

Medida de resultado
Descrição da medida
Prazo
Time to use (for on-demand PrEP) at 1.5 months
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 18 months
Pharmacy-level; binary outcome: % of PrEP/PEP clients who tested positive
18 months
HIV risk
Prazo: 18 months post implementation
Inidiviudal-level; binary outcome: % of PrEP/PEP clients reporting specific behaviors (i.e., multiple sex partners)
18 months post implementation

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Fred Hutchinson Cancer Center

Colaboradores

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

Investigadores

  • Cadeira de estudo: Kendall V Harkey, Fred Hutch Cancer Center
  • Cadeira de estudo: Rachel C Malen, Fred Hutch Cancer Center
  • Investigador principal: Katrina F Ortblad, Fred Hutch Cancer Center

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

1 de outubro de 2026

Conclusão Primária (Estimado)

31 de março de 2028

Conclusão do estudo (Estimado)

30 de setembro de 2028

Datas de inscrição no estudo

Enviado pela primeira vez

24 de abril de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

24 de abril de 2026

Primeira postagem (Real)

1 de maio de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

11 de maio de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

7 de maio de 2026

Última verificação

1 de maio de 2026

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Outros números de identificação do estudo

  • RG1125680
  • R01MH140465 (Concessão/Contrato do NIH dos EUA)

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

SIM

Descrição do plano IPD

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.

Prazo de Compartilhamento de IPD

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

Critérios de acesso de compartilhamento IPD

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.

Tipo de informação de suporte de compartilhamento de IPD

  • PROTOCOLO DE ESTUDO
  • SEIVA
  • CIF

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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