Pharmacy Clinics Give Physicians an Edge

Retail health clinics are an untapped source of data that could help physicians diagnose infectious diseases more accurately, a new study finds. By providing doctors with real-time, local information about which diseases are being treated, pharmacy-based clinics could help prevent false positives and missed cases, according to the study published in the September issue of the Annals of Internal Medicine.

To learn whether such data could influence patient care, researchers Andrew Fine, MD, MPH and Kenneth Mandl, MD, MPH, of the Children’s Hospital Boston, looked at strep throat—a disease that is frequently misdiagnosed and overtreated with antibiotics. When a patient’s symptoms suggest strep throat, physicians use an evidence-based symptom scale called the Centor score to decide whether or not a strep test is warranted.

For the study, Drs. Mandl and Find designed a new, local measure of disease prevalance, called “recent local proportion positive” (RLPP). It describes the number of patients who tested positive for a disease in a specific area relative to the total number patients tested in a given time period. The researchers tested RLPP using data on 82,062 patients who were treated for strep throat at CVS MinuteClinics located across 6 states.

Using RLPP to adjust Centor scores “could significantly impact a patient’s chance of having strep throat and, as a result, diagnosis and treatment,” according to a news release on the study. Given the 10.5 million patient visits that occur each year due to strep, the tool’s cumulative impact would be significant: 166,616 fewer patients treated with unnecessary antibiotics and 62,537 fewer missed cases of strep, the authors estimated.

The finding is a testament to the value of data-sharing and collaborative care, according to Andrew Sussman, MD, president of CVS MinuteClinic. “The work demonstrates how our clinics collaborate with other health care providers to improve individual patient care by accessing aggregate patient data and integrating efforts,” he said.