Regina pharmacy runs innovative study on point-of-care HIV testing

A Regina pharmacy is spearheading an innovative study of point-of-care testing for HIV. Christie MatechukChristie Matechuk, Wellness Pharmacy Canterbury Park pharmacy manager, said the six-month study from December 1, 2018 to the end of May will show how pharmacists can integrate point-of-care testing into their workflow, and how that can increase access to care, HIV detection, awareness, and pharmacy scope of practice.“The best part about this is it’s opened us up, as pharmacists, to conversations with patients that we normally wouldn’t be having,” Matechuk said.Recent studies show Saskatchewan has the highest rate of HIV infection in Canada, and about one in four individuals with HIV are not aware of their status or receiving the treatment they need to suppress the virus. That spurred Wellness Wheel, a nonprofit organization working to improve access for such chronic diseases as HIV, to initiate the study along with a “Get Tested” guide, according to Suzanne Nicolay, clinic and project coordinator.Tests are offered every Monday and Wednesday all day, Matechuk said, with a 100% offer rate, meaning tests are offered to “every patient who walks in the door” provided they are over 18. In the first month, the offer rate was 80%, she adds, with all offers and responses recorded.Three pharmacists are trained to use the point-of-care tests, which involve a finger-poke test for HIV1/HIV2 antibodies, similar to a blood-glucose test for diabetes. The sample of blood is mixed into a three-part solution, put into a screening membrane. The test isn’t diagnostic, Matechuk explained, but it does show whether the person is reactive, at which point a public health nurse on site can immediately draw blood for further testing.Study goals include increasing awareness and access to testing and care, and improving the provincial statistics for people who know their status, Matechuk said.“Our uptake has been so positive, even from the people who have declined,” she added. “And even if that patient does decline the test, their awareness and their knowledge has heightened.”AIDS is transmitted by such activities as intravenous drug use or sharing unsafe needles, as well as unsafe sex. Located in the core area of Regina, Matechuk said the pharmacy’s population includes those who may be “more transient, and maybe engaging in harmful behaviors that could be at risk for HIV transmission. So they might feel more comfortable coming into the pharmacy and getting a test that really only takes a couple of minutes.”“HIV is not a death sentence,” Matechuk said. “It’s extremely treatable.”In the study design, the pharmacy established community links to offer patient support and care. For example, patients who test positive are put in touch with the public health nurse and the Infectious Disease clinic for support.Jeana Wendel, Saskatchewan College of Pharmacy Professionals (SCPP) registrar, said SCPP was consulted, and the pharmacy applied for and obtained a laboratory license for the study. Currently community pharmacists may not order tests until amendments are made to the Medical Laboratory Licensing Act, so obtaining a laboratory license kept the pharmacists compliant with the legislation.“Based on the meetings we had with Susanne, we were satisfied with the ethics consultation, the laboratory license and the safety and considerations for the patients to ensure they were properly supported with the systems in place should there be a positive test result,” Wendel said.Typical treatment may include opioid substitution therapy (OTS), most often with methadone, as well as anti-retrovirals. Matechuk pointed out there have been studies that show patients who are taking their medication regimen properly can have a zero-viral-load in their blood, which means they would not transmit the disease to partners.“Now, with all the HIV treatment and mediations and care, you can live a very long and healthy life.”

Regina pharmacy runs innovative study on point-of-care HIV testing

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