Background:Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV)
prevention is highly effective. Pharmacists can increase PrEP accessibility
through pharmacist prescribing. This study aimed to determine pharmacists’
acceptance of a pharmacist PrEP prescribing service in Nova Scotia.Methods:A triangulation mixed methods study consisting of an online survey and
qualitative interviews was conducted with Nova Scotia community pharmacists.
The survey questionnaire and qualitative interview guide were underpinned by
the 7 constructs of the Theoretical Framework of Acceptability (affective
attitude, burden, ethicality, opportunity costs, intervention coherence,
perceived effectiveness and self-efficacy). Survey data were analyzed
descriptively and with ordinal logistic regression to determine associations
between variables. Interview transcripts were deductively coded according to
the same constructs and then inductively coded to identify themes within
each construct.Results:A total of 214 community pharmacists completed the survey, and 19 completed
the interview. Pharmacists were positive about PrEP prescribing in the
constructs of affective attitude (improved access), ethicality (benefits
communities), intervention coherence (practice alignment) and self-efficacy
(role). Pharmacists expressed concerns about burden (increased workload),
opportunity costs (time to provide the service) and perceived effectiveness
(education/training, public awareness, laboratory test ordering and
reimbursement).Conclusion:A PrEP prescribing service has mixed acceptability to Nova Scotia pharmacists
yet represents a model of service delivery to increase PrEP access to
underserved populations. Future service development must consider
pharmacists’ workload, education and training as well as factors relating to
laboratory test ordering and reimbursement.