The key opinion leader discusses the patient education needed and how pharmacists can improve their knowledge.
Christopher D. Altman, PharmD: Providing education to parents around drug testing is definitely something that we can do better. As pharmacists, we don’t really have reliable, quick tools to give to a patient to say which tests do what and why. Oftentimes, we’re relying on whatever is on the box. We’re looking at the box the same way a patient would with a different level of knowledge, because we understand a little bit more about what we’re testing. There is that opportunity to give the patients a good tool to say, “This is why you should use this, and this is what it’s testing.” I think that’s an opportunity where we can do better to help drive home the message of what the kit is.
For caregivers to actually open up that conversation, we do a lot of counseling as we’re dispensing medications, in general, just to get the patients to understand what the medication is and how to use it. We do discuss some behaviors that could be indicative of abuse, but again, I think that’s an opportunity for us to get good resources that are available with the kits, alongside the kits, or even on the packaging of the kit itself. For example, is there something we should put on the outside of that package, or is there a pamphlet or a brochure we can provide them with to understand how and why to use the kit, as well as those conversation starters?
Going back to that stigma, if the patient doesn’t understand why we’re doing the test and that the person really wants to help them, that is a big opportunity to get those conversations started so it goes down the right path for the patient.
What we can do, as pharmacists, to help dismiss the stigma is have open, honest conversation, make the kits easy to access, make them available, and make resources available, when we have them. To me it’s an access point. If more people are doing it, the stigma will go down. If more people understand it, the stigma will go down.
Most commonly, when patients are in the pharmacy looking for a kit, they’re asking us what the kit tests for. A lot of times, the kits will have the class of medication. It might say opioids, but they’re in there because they want to test for oxycodone or Vicodin. They know the drug, but they don’t necessarily know the class. The other thing is, they want to know which kit is appropriate, because the kits can test for 1 drug, or they can test for 10 things. There’s a range of different things, and we always run the risk of not testing for the right thing if the patients don’t know what they’re looking for.
Oftentimes, they want to know, “How quickly will I get my results, and how accurate are the results?” Often, they want to know right on the spot, and they want to know if it’s accurate and how they can validate that. I’ve had patients come in and buy the test, go home and do it straightaway, and then come back to me with questions later in the day. They want to know, “How quickly will I get results and what am I testing for?”
For pharmacists, I don’t think there are a lot of good resources available. I know there are some resources out there on the Web that we can pull. I don’t see a lot of stuff when I’m in and out of stores that give pharmacists a clear picture of this, that, and the other, as far as what kits are available, which I think is an opportunity for us. What we’re using most often is the kit itself, so we’re reading whatever is on the box. We’re helping the patients understand, if it says opioid, what that means, or if it says amphetamine, what that means. We’re leveraging the box and the kit there, but that’s definitely something we could do better to help provide our pharmacists.
For drug testing kits, I think about it in the same way we provide education on blood glucose monitors. Oftentimes, pharmacies will have a 1-pager that says “These are the monitors. These are the things you need to know about it.” It’s similar information, like how much blood, how much urine, and how long it takes. The kits for the monitors will tell you how long it takes to get the results back. Something similar to that would be a really handy tool for pharmacists. It could include what the store carries, and additionally, some of the other kits that we may not carry. Again, we’re ready to answer those questions, and if patients are needing a kit like a hair test, we can at least tell them what is available so they can then seek it out elsewhere or we can help them find it. That’s a resource a pharmacist could really use.
Within all of that, it can explain the differences and help them with some of those conversations, as well, because we talked about the understanding that the patients need, and the person administering the test needs to be comfortable with those conversations. That’s another resource that we could have, in addition: a quick conversation guide to give the patient to say, “This is how I recommend you have the conversation,” so that they can have a good, confident conversation with whomever they’re testing.
My first recommendation for a pharmacist is, go look to see what you carry. Particularly within community retail chain pharmacies, we don’t always make the decisions about what’s on our shelves out front. We don’t stock those shelves out front; someone else is doing that. I really urge them to get out of the pharmacy, go look at what’s out there so they know what’s available, and then at least learn what those kits are doing, how they work, and the ins and outs of them so they can answer those questions quickly. On the other side, take a minute to learn what’s available in the marketplace and reach out to see what other kits are available. Reach out to whoever in your area is doing good. Call the crisis lines in your area and say, “What are you recommending to your patients who are coming in,” or, “What are you telling people when they ask you questions?” Doing some research on your own side is helpful, starting with what you carry and what it does; that way you can answer those questions for your patients.