Link-up Rx

Summary

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.

This project is part of CIE's Equity in Evaluation Project, which aims to provide organizations that developed innovative service delivery models with evaluation support so that they can collect data to demonstrate effectiveness.

Implementation Resources

Implementation Guide

Intervention Summary

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.

Supplementary Resources