Evaluation of a community pharmacy–based influenza and group A streptococcal pharyngitis disease management program using polymerase chain reaction point-of-care testing

Donald G. Klepser, Michael E. Klepser, Janice S. Murry, Hamilton Borden, Keith M. Olsen

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Objectives: The purpose of this study was to demonstrate the feasibility of implementing a Clinical Laboratory Improvement Amendments–waived real-time polymerase chain reaction (PCR) molecular test into a community pharmacy setting as part of a collaborative influenza and group A Streptococcus (GAS) disease management program. Setting and participants: Two community pharmacy sites in Tennessee. Practice description: Patients presenting to the pharmacy with symptoms consistent with influenza or GAS from November 1, 2016, to April 30, 2018. Practice innovation: Influenza and GAS management programs based on previously developed protocols occurred at 2 community pharmacies in Tennessee. Pharmacies used the Cobas Liat testing system (Roche Diagnostics). Based on test results and under a collaborative practice agreement, pharmacists dispensed prescription medications for patients with a positive test: oseltamivir for influenza and amoxicillin for GAS. Patients with negative tests were treated with over-the-counter (OTC) medications or referred. Patients testing negative for GAS were asked to consent to having a second throat swab sent for culture. Evaluation: Number of patients tested, point-of-care test results, and treatment received. Results: Two hundred and two patients received care at the 2 pharmacies (116 for influenza, 46 for GAS, and 43 for both). Sixty (38%) tested positive for influenza, with 51 receiving an antiviral prescription, and 16 (18%) tested positive and were treated for GAS. No patient testing negative for either or positive for influenza was dispensed an antibiotic. For patients consenting to a follow-up culture, all GAS cultures sent for confirmatory testing were negative. Conclusion: A protocol-driven community pharmacy–based disease management program using real-time PCR testing for influenza and GAS was able to offer appropriate treatment to patients without overuse of antibiotics.

Original languageEnglish (US)
Pages (from-to)872-879
Number of pages8
JournalJournal of the American Pharmacists Association
Volume59
Issue number6
DOIs
StatePublished - Nov 1 2019

ASJC Scopus subject areas

  • Pharmacology (nursing)
  • Pharmacy
  • Pharmacology

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