“There hasn’t been a push to identify patients in the emergency department”—Staff perspectives on automated identification of candidates for pre-exposure prophylaxis (PrEP): A qualitative study

• DOI: 10.1371/journal.pone.0300540
• Publication Date: 2024-03-14T17:40:33Z
• Authors: Samantha A. Devlin; Amy K. Johnson; Kimberly A. Stanford; Sadia Haider; Jessica P. Ridgway
• Keywords: Identification; Pre-exposure prophylaxis; Exploratory research

Automated algorithms for identifying potential pre-exposure prophylaxis (PrEP) candidates are effective among men, yet often fail to detect cisgender women (hereafter referred as “women”) who would most benefit from PrEP. The emergency department (ED) is an opportune setting implementing automated identification of PrEP candidates, but there logistical and practical challenges at the individual, provider, system level. In this study, we aimed understand existing processes explore determinants incorporating within ED, with specific considerations ciswomen, through a focus group individual interviews ED staff. From May July 2021, conducted semi-structured qualitative 4 physicians patient advocates working in high-volume Chicago. Transcripts were coded using Dedoose software analyzed common themes. our exploratory found three major themes: 1) Limited knowledge staff, particularly regarding its use women; 2) does not have standardized process assessing HIV risk; 3) Perspectives on barriers/facilitators utilizing algorithm ideal candidates. Overall, staff had minimal understanding need women. However, participants recognized utility electronic medical record (EMR)-based identify ED. Facilitators included organizational support/staff buy-in, trust, dedicated support follow-up/referral care. Barriers reported by time constraints, hesitancy providers prescribe due follow-up concerns, biases or oversight resulting missing inaccurate information EMR. Further research needed determine feasibility acceptability EMR-based predictive risk setting.