TY - JOUR
T1 - Evaluation of a community pharmacy–based influenza and group A streptococcal pharyngitis disease management program using polymerase chain reaction point-of-care testing
AU - Klepser, Donald G.
AU - Klepser, Michael E.
AU - Murry, Janice S.
AU - Borden, Hamilton
AU - Olsen, Keith M.
N1 - Funding Information:
Funding: This research was funded in part by a grant from Roche Diagnostics. Disclosure: Donald G. Klepser, Michael E. Klepser, and Keith M. Olsen are codevelopers of the Community Pharmacy–Based Point-of-Care Testing Certificate Program and receive paid honoraria and royalties for presentations and consulting. Donald G. Klepser and Michael E. Klepser have received money for consulting services from Roche Diagnostics. The other authors declare no relevant conflicts of interest or financial relationships.
Publisher Copyright:
© 2019 American Pharmacists Association®
PY - 2019/11/1
Y1 - 2019/11/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.japh.2019.07.011
DO - 10.1016/j.japh.2019.07.011
M3 - Article
C2 - 31474527
AN - SCOPUS:85071396744
SN - 1544-3191
VL - 59
SP - 872
EP - 879
JO - Journal of the American Pharmacists Association
JF - Journal of the American Pharmacists Association
IS - 6
ER -