Bias Reduction Training for Pharmacists Prescribing PrEP

Overseen By Abubaker I Saeed

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: Inability to provide consent

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

70 Participants Needed

Trial Summary

What is the purpose of this trial?

This study will follow the ADAPT-ITT model to apply the Prejudice Habit Breaking Intervention (PHBI) to pharmacists who have experience with or are willing to prescribe PrEP. We will first collect qualitative data through focus group discussions guided by the Health Equity Implementation Framework (HEIF) on determinants related to the intervention itself, pharmacists, and the community pharmacy context that may impact implementation of the PHBI. Then, we will use this information to adapt the PHBI in an iterative process involving topic experts, pharmacists, and PrEP users. We will then determine the feasibility, acceptability, and preliminary impact of the adapted PHBI to reduce implicit racial bias.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment The adapted PHBI for pharmacists prescribing PrEP?

The research suggests that training interventions, like the one-hour provider intervention integrating PrEP and cultural competence training, can increase knowledge and confidence in prescribing PrEP. Additionally, pharmacy-based initiatives and training for pharmacists have been recommended to improve PrEP use, indicating that similar bias reduction training could be effective. ^{1 2 3 4 5}

How is the adapted PHBI treatment for bias reduction in pharmacists prescribing PrEP different from other treatments?

The adapted PHBI treatment is unique because it focuses on reducing cognitive and implicit biases in pharmacists, which can improve decision-making and promote equitable healthcare. Unlike traditional medical treatments, this approach uses educational strategies and simulations to address biases, which is a novel method in the context of prescribing PrEP. ^{6 7 8 9 10}

Eligibility Criteria

This trial is for pharmacists who have experience with or are open to prescribing PrEP, a medication that helps prevent HIV. The study aims to train them to reduce implicit racial bias in their service.

Inclusion Criteria

Pharmacy managers: Individual designated by a pharmacy owner to manage a pharmacy, managing pharmacies located in the specified areas.

Pharmacy interns: Pharmacy intern currently registered as a regular student in the School of Pharmacy, Bouvé College of Health Sciences at Northeastern University, Boston, MA, doing the internship in pharmacies located in cities with the highest average annual rate of HIV infection diagnosis in Suffolk County, MA, with experience with PrEP or willingness to prescribe PrEP in the future, and moderate to high preference for White people as measured by the Implicit Association Test.

Pharmacy policymaker: Official employee of the Boards of Registration in Pharmacy directly related to community pharmacy practice.

Exclusion Criteria

Unwillingness to provide consent

Inability to provide consent (e.g., intoxication)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention Adaptation

Adaptation of the Prejudice Habit Breaking Intervention (PHBI) using the ADAPT-ITT model and Health Equity Implementation Framework (HEIF)

8 weeks

Iterative process involving topic experts, pharmacists, and PrEP users

Intervention Implementation

Randomized pilot trial comparing the adapted PHBI versus a control involving an online NIH course on implicit bias

8 weeks

Participants complete intervention and control activities

Follow-up

Participants are monitored for reduction in implicit racial bias using the Race Implicit Association Test (IAT)

8 weeks

Final follow-up visit to assess outcomes

Treatment Details

Interventions

• The adapted PHBI

Trial Overview The study tests two interventions: the NIH Implicit Bias course and an adapted version of the Prejudice Habit Breaking Intervention (PHBI). It will assess how these can help pharmacists serve patients more equitably.

Participant Groups

Group I: The adapted PHBI Experimental Treatment 1 Intervention

The intervention group will be given access to the adapted PHBI.

Group II: NIH Implicit Bias course Active Control 1 Intervention

The control group will be instructed to take the course, "NIH Implicit Bias".

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

References

1. United States pubmed.ncbi.nlm.nih.gov

Provider Implicit Bias in Prescribing HIV Pre-exposure Prophylaxis (PrEP) to People Who Inject Drugs. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Effects of knowledge and implicit biases on pharmacy students' decision-making regarding pre-exposure prophylaxis for HIV prevention: A vignette-based experimental study. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Acceptability and Effectiveness of a One-Hour Healthcare Provider Intervention Integrating HIV Pre-Exposure Prophylaxis and Cultural Competence Training. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

An Experimental Study of the Effects of Patient Race, Sexual Orientation, and Injection Drug Use on Providers' PrEP-Related Clinical Judgments. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Pharmacy-Based Interventions to Increase Use of HIV Pre-exposure Prophylaxis in the United States: A Scoping Review. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Educational strategies in the health professions to mitigate cognitive and implicit bias impact on decision making: a scoping review. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Implicit Bias and Patient Care: Mitigating Bias, Preventing Harm. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

An exploratory qualitative study of pharmacy student perspectives of implicit bias in pharmacy practice. [2023]

9. England pubmed.ncbi.nlm.nih.gov

Confronting implicit bias toward patients: a scoping review of post-graduate physician curricula. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Correlation Between Pharmacy Students' Implicit Bias Scores, Explicit Bias Scores, and Responses to Clinical Cases. [2023]