Rhode Island Pharmacists Take Steps Towards Provider Status

Pharmacists offer prophylactic Lyme Disease antibiotics without physician visit.

For the first time, pharmacists in Rhode Island are able to offer patients antibiotic treatment to reduce the risk of Lyme disease without a physician visit, according to a press release from the University of Rhode Island (URI). This is a step towards gaining provider status for pharmacists, which has been debated in the Senate.

The first-of-its-kind initiative is a collaboration between the URI College of Pharmacy, Green Line Apothecary, Seaside Pharmacy, and Fredric Silverblatt, MD, an infectious disease specialist.

The program trains pharmacists to provide antibiotic treatment with oversight from Dr Silverblatt. In June 2017, Green Line Apothecary was the first US pharmacy to provide a 200-mg dose of doxycycline without a prescription, according to the release. During the first 3 weeks, the pharmacy administered 20 doses of the treatment.

“It’s been much more popular than I thought it would be,” said Christina Procaccianti, PharmD, owner of the pharmacy. “It’s been very rewarding. If this can help prevent one case of Lyme disease, it’s worth it.”

Speedy treatment with doxycycline is known to be a critical factor in treating Lyme disease. Making the antibiotics available without a prescription can dramatically reduce the risk of the illness, according to the release.

“Due to the time-sensitivity of treatment, community pharmacies like Green Line and Seaside are ideal practice locations,” said Anita Jacobson, PharmD, professor of pharmacy at URI and the program’s catalyst. “The availability and convenience of a pharmacy are important to potentially preventing development of Lyme disease.”

The prophylactic treatment will soon be offered at Seaside Pharmacy as well.

Importantly, Procaccianti said that assessing patients and administering the antibiotics to eligible patients does not interfere with other pharmacy activities and it gives students a chance to participate in innovative programs, according to the release.

“It takes about the same time as filling a prescription, and it is exciting for the students (URI pharmacy interns) who get a chance to see a collaborative practice agreement in a real-life setting,” Procaccianti said.

Pharmacy care may also be beneficial for tourists or for those who cannot seek immediate care for their providers. Thus far, several tourists have received the services.

Under the program, pharmacists assess the patients to determine whether they meet the CDC’s criteria: antibiotics can be given to patients 8 years and older, have had a deer tick attached to the skin for at least 36 hours, and had it removed less than 72 hours prior, according to URI.

Procaccianti said the pharmacy has not treated several patients who did not meet the criteria or removed insects that were not ticks. Education is an important aspect of the program, so patients receive a handout regarding tick-borne illnesses, treatment, and prevention measures, according to the release.

The program was initially conceived in 2012 and its efficacy and practicality was explored through a study. The researchers found that no patients developed Lyme Disease or adverse events after prophylactic Lyme Disease treatment, URI concluded.