In Indiana HIV Outbreak, Pharmacists Spearhead Disease Education

Amid an HIV outbreak in Indiana and associated public health emergency declaration from Gov. Mike Pence yesterday, the pharmacist’s role as a disease educator is moving to the forefront.

“Pharmacists can educate [HIV-infected patients] about risk reduction strategies, advocate for testing and testing frequency, and refer them to community sites to access services, such as testing,” said Eric K. Farmer, PharmD, BCPS, AAHIVP, an HIV clinical pharmacist at Indiana University Health’s Life Care Clinic, in an exclusive interview with Pharmacy Times. “Of course, pharmacists can always counsel on good sexual health practices, and other kinds of services that are available, like pre-exposure prophylaxis.”

Public health officials have linked the 79 HIV cases reported in Scott County, Indiana, in recent months to intravenous drug use, according to The Indianapolis Star.

Locally and nationally, pharmacists should address adherence to HIV treatment and any other medications the patient might be taking, including OTC medicines, during each patient interaction, Dr. Farmer said.

Additionally, pharmacists could bridge the gap between patients and other health care team members by encouraging patients to understand their lab test results and various medications. Pharmacists should also stress the importance of bringing complete medication lists when visiting health care providers, Dr. Farmer said.

Staying aware of antiretroviral medications stocks should be a particular focus for pharmacists, especially in community pharmacies that might not stock the therapies regularly, Dr. Farmer stressed.

“These are typically medicines that patients cannot go without, so pharmacists should problem-solve ways to get a patient a 3-day supply until some can be ordered, or refer a patient somewhere else where they can access medications,” Dr. Farmer told Pharmacy Times. “For retail pharmacies, it’s very common to have a medication-stocking issue with antiretrovirals. These are very expensive medications, and they’re very expensive to have sitting on the pharmacy shelves, so a lot of times, pharmacies won’t carry them unless they know they have a patient that is on them.”

Dr. Farmer recommended understanding the local and regional HIV resources available to patients and providers, including AIDS Education and Training Centers or the Clinicians Consultation Center. Pharmacists can also find local and regional HIV and AIDS clinics and then refer concerned patients to these resources.

Dr. Farmer offered 2 key pieces of advice for pharmacists who may encounter HIV-related questions.

“I always tell my pharmacy colleagues to consider any drug interaction with an antiretroviral significant, until they learn otherwise. Regardless of when you graduated, seek out and do a continuing education credit on HIV,” Dr. Farmer told Pharmacy Times. “In the last year, there have been 4 new antiretrovirals that have come on the market, so things are changing rapidly.”