ePrEP Consultation v1
Research type
Research Study
Full title
The Scottish ePrEP Clinic: ePrEP Consultation Study
IRAS ID
325888
Contact name
Claudia Estcourt
Contact email
Sponsor organisation
Glasgow Caledonian University
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
0 years, 6 months, 22 days
Research summary
Summary of Research
HIV pre-exposure prophylaxis (PrEP) is a form of HIV prevention in which people take anti-HIV medication to prevent them from acquiring HIV. Scotland provides PrEP through sexual health clinics. PrEP has successfully reduced HIV infections and underpins Scotland’s goal of preventing all new cases of HIV by 2030 (HIV transmission elimination). To achieve HIV transmission elimination, PrEP needs to reach all people who could benefit, in ways that offer good value to the NHS. Currently, sexual health clinics are struggling to meet demand. Digital (online) healthcare could provide PrEP at scale in a way that people find appealing.
We are developing an online PrEP service (the ePrEP clinic) to give PrEP users the option to complete routine monitoring at home/online rather than having to attend a sexual health clinic. Specifically, the ePrEP clinic will require people to collect their own samples to test for HIV and other sexually transmitted infections and complete an online medical questionnaire (online consultation). The online consultation checks if it is safe to provide more PrEP straight away or if additional information is required through discussion with a health care professional (“clinical input”). This might happen, for example, if a person has started a new medication. Depending on the test results and questionnaire responses, a healthcare professional will either 1) prescribe more PrEP or 2) contact the PrEP user to discuss any issues and provide appropriate care (clinical input).
In this study, we will evaluate how good the medical questionnaire is at determining if PrEP users need clinical input before receiving more PrEP. We will ask PrEP users at Sandyford Sexual Health Services to complete a paper version of the online consultation immediately before their in-clinic PrEP appointment and compare the outcome of the questionnaire with the decision made by the healthcare professional during the in-clinic appointment.
Summary of Results
In this study, we aimed to test how good our online questionnaire was at collecting the information needed to inform safe repeat prescribing of a HIV prevention medication called HIV pre-exposure prophylaxis (PrEP).
The questionnaire will be used by people who have been on PrEP a while and who do not have any complex medical needs. The questionnaire will act as a check-in between full, standard appointments with a healthcare professional, providing an opportunity to see if there are any relevant changes to the user’s health that might need to be discussed before more PrEP is prescribed.
In this study, we asked PrEP service users to complete a paper version of our questionnaire immediately before their standard PrEP appointment, which they have face-to-face with a healthcare professional. Participants put the completed questionnaires in a locked box, so their healthcare professional did not see this.
We compared participants’ questionnaire responses with the information entered in their electronic patient notes by the healthcare professional during the standard appointment.
Fifty-nine people completed our questionnaire. Their overall characteristics (for example, gender and ethnic background) were largely representative of PrEP service users in our health board.Our study doctors would have (hypothetically) prescribed PrEP to all participants based on their questionnaire answers. This was in full agreement with the decisions made by the healthcare professionals during the standard appointments. Nobody had PrEP withheld, which is to be expected as our eligibility criteria focused on established PrEP users with no complex medical needs.
Three participants reported new information during their standard appointment that they did not include in their questionnaire. Two participants reported new information in our questionnaire that was not included in their patient notes. None of the extra information would have affected PrEP prescribing. However, we did make some minor changes to our questions, mainly giving more examples of the types of information we were looking for.
Overall, our questionnaire performed well when compared to standard PrEP appointments, and this study helped us identity opportunities to make further improvements.
REC name
East of Scotland Research Ethics Service REC 2
REC reference
23/ES/0030
Date of REC Opinion
9 Aug 2023
REC opinion
Further Information Favourable Opinion