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Table 3 Clinic level implementation barriers to LA ART and proposed solutions

From: Multi-level considerations for optimal implementation of long-acting injectable antiretroviral therapy to treat people living with HIV: perspectives of health care providers participating in phase 3 trials

Themes Provider Responses
Perceived Barriers Salient Proposed Solutions with
Representative Quotes
Capacity to meet demand “Keeping track of timing/scheduling of patient appointments, window for injections & follow up with patients that miss injections.” (U.S. provider) Train clinic staff
“Logistics collaboration, training of health personnel, access and infrastructure” (Argentinian provider)
“Infrastructure in the centers for its application and conservation of the drug.” (Argentinian provider) Designate staff/space for injections
“Dedicated clinic or team” (Italian provider)
“Injection rooms and specialists dedicated to the provision of injections, providing incentives to the staff involved in the administration of injections” (South Korean provider)
“We would need to organize a team to look at assigning personnel to be in charge of supply, education, administration, and patient retention.” (U.S. provider)
“Staff coordination for delivery of injections.” (South Korean provider)
“Need of personnel and physical space for its administration” (Spanish provider)
“Clinic time demands for injections” (U.S. provider) Establish workflows and protocols
“Suggested workflow example of a typical patient injection visit” (Australian provider)
“Work the injection appointments into clinic flow/create template for scheduling injection visits; staff training (drug ordering and storage, administration of injections, follow up/window allowed for injections); pharmacy tech trained on prior authorizations/insurance” (U.S. provider)
“The need for specialized administration personnel.” (Spanish provider)
Cold chain logistics “The need for a strict cold chain.” (Russian provider) Train clinic staff
“Training in clinics to educate staff about temperature needed to keep medications at and importance of proper dosing and temperature of medications.” (U.S. provider)
“Cold chain in rural areas” (South African provider)
“Cold chain issues. Drug only free at one pharmacy in Melbourne and cold chain would therefore be broken.” (Australian provider) Adequate refrigeration and storage facilities
“Would potentially need medication sent by a courier if patients don't wish to pay for it to ensure cold chain maintained.” (Australian provider)