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Let’s talk about sex(ual health)

Almost $2M in federal funding for pharmacy-based sexual health services model

By Kim Devlin

A School of Pharmacy researcher is taking her research program to the next level, thanks to a significant grant from the Canadian Institutes of Health Research (CIHR).

Dr. Debbie Kelly, professor, pharmacist and the director of the School of Pharmacy’s Medication Therapy Services Clinic at Memorial University, and her project team based throughout Atlantic Canada, Ontario and Alberta, have been awarded $1,916,463 over a five-year period for their project titled, Improving Sexual Health for Canadians through a Pharmacy-based Sexual Health Services (PbSHS) model.

The funding is being made available through the CIHR Transforming Health with Integrated Care Implementation Science Team Grant.

Dr. Kelly’s team is currently leading a pharmacy-based testing study for HIV, hepatitis C and syphilis throughout N.L., N.S. and Alberta.
Photo: Submitted

Improving access

Mark Holland, federal minister of Health, announced the award on Oct. 20.

“Health research is paramount to ensuring that Canadians have access to world-class health-care,” he said. “With this investment today, we are continuing our record of investing in research as part of our commitment to strengthen health care in communities across the country. These research teams will address important health challenges we are facing, and their work will lead to improved care and better health outcomes for people living with serious health conditions.”

Sexually transmitted and bloodborne infections (STBBIs), including HIV, hepatitis C and syphilis, are on the rise in Canada.

The country’s health-care system has limited capacity to meet the demand for sexual health service delivery. Transformative interventions in the way we screen, prevent and treat STBBIs are needed.

There are effective preventions and treatments for STBBIs, but many Canadians don’t have access to health-care professionals and the settings to receive this care.

The situation is even more dire for vulnerable populations, such as the LGBTQ+ community, people who use drugs, and racially diverse and immigrant populations.

Urgent need

Building upon research findings from completed and in-progress projects from across Canada, Dr. Kelly’s project aims to formalize a pharmacy-based sexual health service model beyond research projects into a regular, sustained health-care delivery service.

This would allow people to access testing for STBBIs and receive both prevention and treatment medications through their local pharmacy.

“Pharmacists’ scope of practice has increased across the country and study participants have told us that the private room in a pharmacy offers a sense of discretion to access sexual health services by a trusted, knowledgeable health-care provider,” said Dr. Kelly. “The PbSHS model has been shown to improve access to care, is preferred by patients, is cost-effective and can find new diagnoses and treat STBBIs, linking people with physician care, as needed.”

The researchers are currently leading a pharmacy-based testing study for HIV, hepatitis C and syphilis throughout Newfoundland and Labrador, Nova Scotia and Alberta.

For more information about the study, including participating pharmacies, please visit the website.

Integrating into existing systems

Dr. Kyle Wilby, Dr. Kelly’s grant co-lead, has led a project on pharmacist-led, HIV pre-exposure prophylaxis in Nova Scotia; other team members are involved in pharmacy-based HIV testing, prevention and STBBI treatment studies.

However, once these PbSHS projects are completed, there is no plan for how to sustain the services.

That’s where Dr. Kelly’s project comes in.

The CIHR grant will fund the project’s plans to integrate the PbSHS model into existing health-care systems.

“We have a track record in Canada of doing really great research that oftentimes doesn’t get translated into meaningful change,” said Dr. Kelly. “This funding opportunity is really exciting because it will allow us to work with partners in the policy and regulatory roles, as well as pharmacy owners, pharmacists and other health-care providers, the community and, most importantly, the users of the health-care system to support widespread implementation and sustainability of the PbSHS model into Canadian provinces.”

The project will occur in three phases, based on a framework for implementation of evidence-based interventions into health-care systems.

“This will help Canadians live healthy lives and reduce transmission of new infections, while supporting an overburdened health-care system.” — Dr. Debbie Kelly

Phase one consists of several projects involving public and stakeholder engagement to assess system readiness, conditions and adaptations needed for a successful scale-up in the Atlantic region and in Alberta.

Phase two involves developing resource tools to support the expansion. Stakeholder feedback will be sought in order to revise the tools and scale-up plans.

National and international importance

Through creating public awareness, legitimizing and activating change and building capacity, phase three aspires to generate an environment ready for the PbSHS model expansion for its long-term implementation into current health-care systems.

The project team has engaged public partners who are invested and will ensure that this is done in a way that improves access to care and enhances the health-care experience and meets patient needs.

The potential impact of this study is of national and international importance because the PbSHS model can contribute to public health goals of reducing STBBIs and linking patients to health care and treatment.

“Through this work, we hope to make it easier for many Canadians to access STBBI testing, prevention and treatment services through their community pharmacies,” said Dr. Kelly. “This will help Canadians live healthy lives and reduce transmission of new infections, while supporting an overburdened health-care system deliver services efficiently and cost-effectively.”

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