Link-Up Rx is a data to care (D2C) program that aims to increase retention in care and viral suppression among people with HIV by using prescription refill information to decrease the length of time between refills and reduce antiretroviral therapy (ART) interruption. The Detroit Health Department implemented Link-Up Rx in partnership with the Michigan Department of Health and Human Services and MedCart Specialty Pharmacy in July 2018.
About the Project
Population: People with HIV not currently accessing HIV care or in need of support to continue taking their HIV medication
Setting: Health Department and Collaboration with Pharmacies
Location: Detroit, MI
Intervention Focus: Linkage, Re-engagement, Retention
Study Period: 2019-2020
Outcomes, Components
Intervention Outcomes
Link-Up Rx applies many of the same principles and strategies of traditional D2C while significantly reducing the time before the health department intervenes to reconnect a client to ART. Before implementing Link-Up Rx, it would take months before a client appeared on the “not in care” list for D2C. Link-Up Rx’s model ensures that the intervention team receives a notification two weeks after a client has not picked up their ART.
Intervention Components
- Step1: Identify Pharmacies/Pharmacists
- Step 2: Develop Protocol for Link-Up Rx
- Step 3: Engage Community
- Step 4: Implement a Three-Tier Re-Engagement Process
- Step 5: Evaluate the Intervention
Challenges and Solutions
| Challenge | Solution |
|---|---|
| Poverty and Other Social Factors | Implementation of practical strategies, programming, and community partnerships; a solid understanding of insurance and insurance navigation; robust referral mechanisms are necessary to support cellphones, utilities, rent, or other needs. |
| Insurance Gaps | To support clients with insurance issues, insurance navigator trained on RWHAP supplemental insurance options, ADAP, Medicaid, private insurance, and Medicare; partnership with a statewide insurance task force to strategize and implement solutions to insurance barriers; |
| Adherence | Work with clients that had medication remaining at the end of each month, including intervention team collaboration with the pharmacy to offer clients different types of packaging to help them remember to take their medication more consistently and offer to enroll clients in text message reminder programs and smartphone apps to assist with taking daily medications. |
