Date of Award
Summer 8-31-2025
Document Type
Doctor of Nursing Practice Final Manuscript
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Joseph Burkard, DNSc, CRNA, EBP-C
Abstract
Patient Education on conversion from oral ART/PrEP to Long-Acting Injectable (LAI) improves patient adherence.
Marnel Reina Mae Hernandez, MSN, RN
Joseph, F. Burkard, DNSc, CRNA, EBP-C
Background: Long-acting injectables (LAI) have been shown to be equally effective in viral load suppression. Implementing nurse led educational interventions in the use of oral treatment to LAI will address if LAI prescriptions can improve adherence and patient retention. Despite the availability of LAI for ART (antiretroviral treatment) and PrEP (pre-exposure prophylaxis for HIV) patients continue to have a low appointment adherence which can impact adherence and overall viral detectability. LAIs will continue to be part of HIV and HIV prevention medicine.
Purpose of Project: This project aimed to implement a patient education program providing educational foundation to nursing staff to optimize the LAI prescribing as an alternative regimen from oral regimen to ensure viral load compliance and follow up appointment and treatment adherence.
EBP Model: The Johns Hopkins Evidence-Based Practice Model supports a problem-solving approach to clinical decision-making and fosters enhanced team collaboration between healthcare center staff, the pharmacy team, and promotion of patient self-efficacy as well as enhancing patient satisfaction and experience.
Evidenced-Based Interventions: This evidence-based intervention provided multi-modal educational resources (exam room QR codes, paper handouts, or e-resource via portal/secured messaging) for staff demonstration on the importance of adhering to oral treatment and completing provider visits in maintaining and preventing HIV transmission risk. The nursing team included registered nurses (RNs), licensed vocational nurses (LVNs), and/or medical assistants (MA) to provide interventions at patient appointment visits as well as using multiple patient communication platforms for care follow-up.
Evaluation/Results: Evaluation of results reviewed institutional/organizational data on completed appointment rates, patient no show rates, pharmacy refill and fill data, and viral load suppression data pre-implementation and post-implementation.
Implications for Practice: The successful implementation of this project allowed more nurse-led educational interventions at the clinic level with the goal of enterprising this technique at multiple clinic sites as a method to improve patient retention and patient treatment adherence.
Conclusion: The initiation of a nurse-led educational intervention designed to improve patient’s basic understanding of continuing their treatment and provided self-efficacy as well as autonomy in their care. Using an educational intervention allowed improvement in overall patient treatment adherence and retain patients in care. The goal will be to standardize this process over multiple clinic sites as an available tool for the clinical team and enhance patient experience.
Keywords: Long-Acting Injectables, Viral Load Suppression, Patient Treatment Adherence
Digital USD Citation
Hernandez, Marnel Reina Mae M., "Patient Education on Conversion from Oral ART/PrEP to Long-Acting Injectable (LAI) to Improve Patient Treatment Adherence" (2025). Doctor of Nursing Practice Final Manuscripts. 316.
https://digital.sandiego.edu/dnp/316
Copyright
Copyright held by the author
