Dr David Koren Discusses Barriers to Implementing Long-Acting Injectables for HIV

Providers have had to implement a completely different HIV medication prescription and delivery paradigm in the last year, said David E. Koren, PharmD, MPH, BCPS, AAHIVP, FIDSA, infectious disease clinical pharmacist at Temple University Hospital.

Transcript

What have you learned about the barriers of implementing long-acting injectables since last year’s guidelines saying they are not suitable for everyone as a replacement ART?

In the last year, we've really learned that the barriers for implementing long-acting injectables come on 2 sides: there's the side of the providers and there's the side of the patients.

For the patient, we want to make sure that they're able to come to their appointments—because, regardless of if it's long-acting therapy, they still have to show up for their appointments—and make sure that they are aware that there is a specific dosing window that everyone has to fall within.

From a provider perspective, we have now had to implement a completely different treatment paradigm into our practices. Before, we may prescribe a medication to a patient and they may be seen once or twice a year in the office, whereas now we have to have all of the infrastructure available, not only for medication acquisition but also for that medication delivery, which was not necessarily a structure that we had, and we have to now grow into.