COVID-19 will change how pharmacists recommend, sell, and use nonprescription options.
Where do most patients go when they get a cough? Yes, the pharmacy.
A simple Google search for cough yields 178 million results. Put in cough and coronavirus, and it spits out 151 million results. That is staggering: In a few short months, Coronavirus disease 2019 has dramatically changed our consciousness and our approach to triaging a common cough. Consider that finding in the context of OTC popularity among Americans, and pharmacists need to think seriously about how they respond to patients with common symptoms, namely a dry cough and fever, typically alleviated by nonprescription products. More than 90% of American adults prefer to self-treat with an OTC product rather than seek professional care, and about 80% of all health care episodes are self-treated.
RECOMMEND OTC PRODUCTS, GET TESTED, STAY AT HOME, OR ALL OF THE ABOVE?
As the country reopens, pharmacists are in an incredibly important position to advance individual patient care and public health. We often take for granted the systemwide care effects of those thousands of times a year that we give advice and recommendations after a quick triage to determine whether a patient or caregiver should seek a formal examination or a higher level of care.
WHAT ABOUT TAKE-HOME TESTING?
There is an abundance of products, both drug and nondrug, procured by consumers over the counter, and new entrants are becoming more advanced and varied. From basic labs and pharmacogenomics to take-home devices that produce an electrocardiogram, sophisticated products that provide continuous monitoring, advanced diagnostics, and treatments are changing the way we operate without prescriptions.
Coronavirus antibody and antigen testing is set to take center stage in track-and-trace efforts and populationlevel monitoring of outbreaks. Millions of grandparents want to see their kids and grandkids. Parents want to send their kids to school and plan their activities and sleepovers. Workplaces want employees to feel safe. Incredible demand may come with rapid onsite testing and take-home tests pre—coronavirus vaccine and perhaps even post vaccine. Hundreds of millions of tests, if not billions in total, may be needed for continuous monitoring.
PROPER INTERPRETATION OF FINDINGS REMAINS A REGULATORY PRIORITY
We are entering a new era of access to more devices, pharmaceuticals, and services from the convenience of our home or without a face-to-face visit with a physician. Regulatory officials, as well as public health authorities, have offered a supportive but tempered view of conferring OTC-level access to many of these newer devices and diagnostics. Interpretation of genetics, the health consequences, and how genetics could influence drug regimens still require a consult with a health care professional. Having ready access to highly technical information about an individual’s heart may be helpful, unless the results are abnormal or the interpretation of what to do next is ambiguous.
EASY ACCESS IS GREAT, BUT COUNSELING BY HEALTH CARE PROVIDERS REMAINS ESSENTIAL
Getting the results of a coronavirus antibody or antigen test requires follow-up counseling for both proper patient care and understanding, as well as protecting public health. The pharmacist’s ability to order testing and counsel patients about test results will continue to advance the idea that consumers can simply go to their corner drugstore to get reliable health care products and services. Even if coronavirus antibody and antigen tests never become nonprescription products, the public’s perception of pharmacists’ near-immediate availability represents an OTC-like product experience, not altogether different from receiving an impromptu counsel on which products are best suited to treat a cough.
PROPER COUNSELING, INTERPRETATION ARE VITAL
As we reopen pharmacy aisles or take OTC-filled coronavirus care packages to the curbside, we must remind ourselves of the breadth and importance of nonprescription products in our health care system. Allergies, chills, coughs, diarrhea, fever, pain, rashes, and other ailments are not going away during the pandemic. The OTC consumer base is more primed than ever to seek advice and counsel on which products to use and which symptoms and disease progressions to watch for among their loved ones. Pharmacists’ recommendations, advice, and provision of OTC products and services are meaningful, regardless of whether a prescription was written.
We hope you enjoy our 2020 OTC Guide®!
Troy Trygstad, PharmD, PhD, MBA, is vice president of pharmacy programs for Community Care of North Carolina, which works collaboratively with more than 1800 medical practices to serve more than 1.6 million Medicaid, Medicare, commercially insured, and uninsured patients. He received his PharmD and MBA degrees from Drake University in Des Moines, Iowa, and a PhD in pharmaceutical outcomes and policy from the University of North Carolina at Chapel Hill. He also serves on the board of directors for the American Pharmacists Association Foundation and the Pharmacy Quality Alliance.