430. Impact of a Pharmacist-Managed Sexually Transmitted Disease (STD) Test Result Review Service at a Veterans Affairs Medical Center

Abstract

BackgroundThe CDC recommends annual STD screenings in all sexually active women ³25 years old and men who have sex with men. Given the increased incidence of STDs and the need to improve their management, in September 2018 infectious diseases clinical pharmacists implemented a pharmacist-managed STD quality improvement project (QI) that reviewed positive STD test results with feedback to providers. We present the results of this QI project below.MethodsThe QI project consisted of prospective, daily reviews of all positive chlamydia, gonorrhea or syphilis tests (post-implementation period: 9/2018 to 2/2019). Patient electronic medical records were reviewed and assessed for the need for additional laboratory tests and to determine whether appropriate treatment was received, with feedback provided to the primary provider. In addition, risk factors were assessed to determine the appropriateness of human immunodeficiency virus (HIV) Pre-Exposure Prophylaxis (PrEP). A retrospective review of positive STD results from 9/2017 to 2/2018 was also conducted (pre-implementation period) for comparison. The purpose of this project was to evaluate the impact of pharmacist test result review on the appropriate testing, review appropriateness of prescribed treatments of patients diagnosed with any STD according to accepted clinical guidelines, and to inform the need for and the areas of focus for educating providers in the emergency room and primary care clinics on the management of these patients. Descriptive statistics, Chi square, and Fisher’s exacts tests were used to analyze the outcomes of the project.ResultsA total of 144 patients were included in the project (pre-implementation, n = 47; post-implementation n = 74). Please refer to the table for other results.ConclusionThe implementation of a pharmacist-managed STD test review service decreased time to treatment and time to STD test result review. More patients in the post-implementation period received appropriate therapy compared with patients in the pre-intervention period. These findings indicate that there is a role for a pharmacist-managed STD test review service in assisting providers with quickly and appropriately connecting patients to care. Disclosures All authors: No reported disclosures.