Expert: Point-of-Care Testing in Pharmacies is Valuable, Pertinent to Expectations of Patients
The value proposition for point-of-care testing in the pharmacy is extensive, as pharmacies can provide a convenient, accessible, and cost-saving alternative for patients.
With the rise of high-deductible health plans and the public’s desire for convenient, accessible health care, pharmacies are well-positioned to grow their point-of-care testing (POCT) niche in today’s consumer market, explained Matthew Meyer, PharmD, owner and pharmacist-in-charge at the Hospital Pharmacy West, during a presentation at the National Community Pharmacists Association 2022 Annual Convention. POCT, which uses a medical device for either diagnosis or screening of a particular illness or disease, can help provide actionable results far more quickly than is otherwise possible.
“[POCT in the pharmacy] is unique in that it is delivered near or at the site of care and you obtain actionable results within minutes,” Meyer said. “There are 4 primary reasons for initiating POCT: to identify disease, improve access to care, monitor parameters for different disease states, and modify patient behaviors in some way or another.”
Additionally, Meyer noted that the value proposition for POCT at the pharmacy is extensive. Pharmacies are convenient, accessible, and cost saving for patients. These benefits can also allow patients to seek and receive diagnoses earlier in a one-stop shop environment in which they can also pick up their medication following a diagnosis, all in the same location.
Meyer explained that the physician shortage has caused significant challenges for patients seeking care, which has caused screening delays and other problems. These concerns make pharmacies additionally valuable to help alleviate some of the burden on physicians and emergency departments due to their staffing challenges.
“We’re currently in a physician shortage all across the nation, and I don’t see any indications that is going to change anytime soon,” Meyer said. “Would you rather sit in a physician’s office for 20 to 30 minutes until a room opens, and then be called back and wait there for 10 minutes to see your provider for 3 minutes, then go to the lab to get your blood drawn, and then wait for another physician to call in your prescription?”
At the pharmacy, this process is shortened significantly, Meyer explained.
“You can see your pharmacist in the first 5 minutes of being there, and then get your results and go on with your day,” Meyer said.
Additionally, there are certain issues facing the health care industry for which pharmacists are particularly able to address through a greater role in patient care, such as the appropriate use of antibiotics. Specifically, for pharmacies practicing antibacterial stewardship, pharmacists can use POCT as a method of determining whether antibiotics are in fact the best treatment for a patient’s illness.
Furthermore, pharmacists also likely have patients’ complete medication records on file, which can allow them to effectively counsel and educate patients on the entirety of their medication regimen and any potential interactions they might experience. Pharmacists can also highlight to patients the importance of communicating their experience of adverse events (AEs), which can then allow pharmacists to take the appropriate action as necessary to help patients when AEs arise.
Meyer noted that there are also some key partnerships when implementing POCT in a pharmacy that are vital to its success, such as pharmacy wholesalers, state associations, and physicians. Additionally, it can be valuable to develop connections with local businesses, such as long-term care and assisted living facilities, which would benefit significantly from a pharmacy offering POCT services.
“When we talk about key supply partnerships, especially if you're new to the game and just starting to get to POCT services, pharmacy wholesalers can be very big buyers in this for us,” Meyer said. “Most of your pharmacy wholesalers are going to have add-on services which provide turnkey solutions. In order to start, you're going to need testing programs, which includes access to analyzers and testing supplies.”
Additionally, Meyer explained that pharmacy wholesalers can give pharmacies starter policies and procedures for each of the tests that are ordered, providing details on required documentation and personal protective equipment. Pharmacy wholesalers can also provide pharmacy staff with access to education and training materials so they can become proficient in using the analyzers and in sample collection preparation. Wholesalers can also offer outreach forms to help pharmacies notify local community providers about their new service offerings.
Physician collaboration is also essential for the success of POCT in the pharmacy, according to Meyer. However, there are limitations in this area, as the extent of the pharmacist’s collaboration with a physician will come down to their state’s regulations in this area. Further, state regulations will also establish whether or not pharmacists have prescriptive authority to order tests or whether they need a collaborative practice agreement for ordering tests and for initiating treatment.
“Your primary pharmacy wholesaler can be of some assistance if you're just getting into it, depending on the state that you that you're currently practicing in. They may have a physician that already signed on to work with them, or they can assist with physician outreach to find physicians who may be interested in pharma practice agreements,” Meyer said. “Also, reach out to the board of pharmacy to review your state’s statutes to determine whether a pharma practice agreement is required, or whether you have that prescriptive authority or not.”
Additionally, Meyer explained that patient referrals are also critically important to the success of POCT in any pharmacy.
“If you really, really want to get your POCT program off the ground and make a successful service, you are at some point going to need those patient referrals,” Meyer said. “It takes time to develop that and the easiest way to get those patient referrals is to time and time again deliver a consistent, reliable product.”
Meyer MJ. The Point-of-Care Testing Playbook. Kansas City, MO: National Community Pharmacists Association 2022 Annual Convention; October 1, 2022.