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New funding to study pharmacist-provided testing


By Heidi Wicks

An estimated 21 per cent of Canadians with HIV are unaware of their infection, possibly because the hurdles for testing are too large to leap over.

Patients who are at the highest risk of infections often feel anxious or socially marginalized, and therefore avoid traditional testing sites such as sexually transmitted infection clinics or doctor’s offices. For these patients, the stigma that goes along with the condition is too much to bear.

Or, a patient simply may not have access to traditional testing sites, especially those who live in rural areas.

As the most accessible and trusted health care professionals, pharmacists are well positioned to improve access to HIV testing by offering rapid Point-of-Care Testing (POCT) in private counselling rooms for patients who may not feel comfortable going to, or have access to, traditional testing sites.

(L-R): Dr. Debbie Kelly and Dr. Jason Kielly
(L-R): Dr. Debbie Kelly and Dr. Jason Kielly are investigating the use of Point-of-Care Testing.
Photo: Chris Hammond

Researchers in the School of Pharmacy have received $150,000 from the Canadian Institutes of Health Research (CIHR) to decipher just how effective offering a POCT program through community pharmacies can be in reducing risk and optimizing access to care for those who test positive.

“With traditional sites, the results can take one to two weeks to receive. Getting the results right away reduces a lot of the anxiety associated with waiting to find out your results.”—Dr. Debbie Kelly

Dr. Debbie Kelly, associate professor and co-principal investigator (along with Dr. Jason Kielly), explained that when patients enter a pharmacy to be tested, there is a sense of anonymity in requesting an HIV test.

“When a patient goes into the private room, no one knows if they’re in there receiving a flu shot, counselling about how to give themselves an insulin injection, or receiving an HIV test. As well, people can request an HIV test by simply writing ‘HIV test please’ on a piece of paper and handing it to a technician, as they would with any prescription,” said Dr. Kelly.

She added that POCTs are easy to administer and provide results immediately, making them ideal for use in the community pharmacy setting.

“With traditional sites, the results can take one to two weeks to receive. Getting the results right away reduces a lot of the anxiety associated with waiting to find out your results.”

Quick test results translate into efficient linkages to care and treatment, and therefore a reduction in the spread of the illness, improved health outcomes and life expectancy, and less of a strain on the healthcare system.

Dr. Kelly, who has been clinical pharmacist to the provincial HIV program since 1999, said Newfoundland and Labrador has recently seen a significant increase in the number of new HIV infections, many of whom are presenting late in the course of their illness and are quite ill.

“We need to be more proactive in identifying infections early, so we can connect people with care and treatment to reverse this unfortunate trend. Making testing more accessible to more people, and minimizing the barriers to testing will hopefully encourage more people to get tested,” she said. “We’ve made great strides in treating and preventing HIV, but patients not getting tested and finding out their status could threaten that progress. We want to move forward, not back.”

The 18-month study will evaluate the acceptability and feasibility of pharmacist-provided testing in Newfoundland and Labrador and in Alberta, including pharmacies in both urban and rural areas.

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