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As community pharmacies strive to play a greater role in population health management, could TB testing be an important item on the service menu?
As community pharmacies strive to play a greater role in population health management, could tuberculosis (TB) testing be an important item on the service menu?
Across the country, more and more pharmacies are offering TB testing services as a way to meet patient demand and to establish themselves as a vital part of the healthcare team.
Courtesy ShutterstockJust this fall, the NACDS Foundation announced the launch of a joint initiative with the University of New Mexico, called Improving Access Project: Tuberculosis Testing and Latent Tuberculosis Infection Treatment in Community Pharmacies.
The primary goals will be to survey patients about their healthcare experience when they receive TB testing in a community setting. Patient health outcomes and access to care when TB testing and latent tuberculosis infection (LTBI) treatment are done at a community pharmacy will be also evaluated.
“We are so excited to be able to support this particular project because it really looks at the accessibility of getting screenings and treatment, at patient adherence and outcomes, and at what we can do working together collaboratively across public health, and commercial endeavors, and academics,” says NACDS Foundation President Kathleen Jaeger.
Seven community pharmacies in New Mexico have agreed to take part in the initiative.
Bernadette Jakeman, Associate Professor with the University of New Mexico College of Pharmacy and the principal investigator of the study, says one aspect will be to step up to help the state’s overwhelmed Department of Health (DOH).
“Their focus really is on treating active TB disease, so this gives us an opportunity to fill in the gaps and help them treat latent TB infection,” she says. As part of the initiative, those patients identified with LTBI through the New Mexico DOH will be given the option to receive treatment through the DOH or to receive weekly treatment with rifapentine and isoniazid (INH) at a participating community pharmacy in their area.
“At the pharmacy they can be evaluated for drug-drug interactions and any potential side effects. Then, if there are labs or anything that needs to be ordered, the pharmacists work with the DOH to get those ordered and followed-up. But otherwise they are followed by the pharmacy directly,” Jakeman says.
Investigators will evaluate whether having improved access to treatment has a positive impact on treatment completion rates and time to being treated.
While the exact impact this will have on treatment outcomes and access has yet to be determined, Jaeger says the NACDS Foundation believes the collaborative partnership is promising. She says community pharmacies are a good partner in population healthcare because they are easier for patients to access compared with other healthcare providers.
“If we can make medical care, whether it be very basic, acute medical care, or even outside this particular research project, or other type of medical interventions more accessible, it really is better for patients and better for the healthcare system,” she says.
But the research initiative isn’t the only venture into providing TB testing at the pharmacy level. Sharon Woodward, PharmD, the Pharmacy Manager at Bartell Drug’s Issaquah, Washington location, says she has been providing TB skin tests at her pharmacy since 2014.
Woodward says she started the service after getting requests from patients. Since she didn’t know of any other nearby pharmacies, clinics, or doctors offering the tests to patients, she decided to add the new service.
“There was certainly a demand for TB testing, so I just needed to become certified to perform the test and obtain a collaborative drug therapy agreement (CDTA) to prescribe tuberculin,” she says.
The pharmacy now offers TB testing as part of its walk-in services. Woodward says she averages about one test per week.
Ric Brewer, Senior Communications Manager at Bartell Drugs, says the new service has been well-received by patients and a great fit for the pharmacy.
“Pharmacists may see patients more often than they are able to visit their doctors, so we are uniquely positioned to be able to monitor their progress or conditions during multiple visits,” he says. “This familiarity also gives pharmacists the ability to monitor reactions or other elements of their healthcare regimen that their primary provider may not get first-hand or in as timely a fashion.”
Jill Sederstrom is a freelance writer based in Kansas City