Assessing pharmacy workflow to enhance the integration of HIV prevention services

Abstract

Background

Community pharmacies are well-positioned to expand access to HIV prevention services, including pre-exposure prophylaxis (PrEP), by offering convenient, community-based care in areas with high HIV burden. Yet, the operational realities of incorporating oral PrEP into existing workflows, particularly within independently owned pharmacies operating under restrictive prescribing policies, remain underexplored. Workflow assessments and task modeling offer an opportunity to inform scalable strategies for service integration.

Objective

To examine community pharmacy workflow patterns and resource use to inform the development of a real-world model for integrating PrEP services into independent pharmacy settings, while ensuring service quality and reducing stigma.

Methods

Structured workflow, resource observations, and hierarchical task analysis (HTA) were conducted in 7 independently owned community pharmacies in high-HIV-prevalence areas of Atlanta, Georgia. Observers recorded routine staffing patterns, task flow, and infrastructure availability. HTA was used to map medication dispensing tasks and identify realistic entry points for PrEP-related services such as counseling, education, and dispensing.

Results

Pharmacies exhibited consistent core dispensing processes but differed in staffing configurations, space for private consultations, and capacity to support additional services. The HTA-informed analysis yielded a composite model aligning PrEP service elements with existing workflows to minimize disruption and support patient-centered care.

Conclusion

This study offers a formative approach to aligning PrEP delivery with routine pharmacy operations through direct workflow analysis and task modeling. The resulting model reflects the unique context of independently owned pharmacies in the U.S. Southeast and provides a practical foundation for future implementation efforts in similar settings.