Pharmacists Step Up on Test-To-Treat This American Pharmacist Month

Pharmacists are among the easiest health care providers for patients to reach, and they could do more to protect public health if state laws allowed it, according to Shantel Upshaw Houston, PharmD, interim executive vice president of the National Pharmaceutical Association (NPhA).

Houston said the profession's biggest strength is how easy it is to get to a pharmacist. Patients can get clinical advice without an appointment or a gatekeeper, whether they walk into a community pharmacy or call a pharmacist who works in another setting.

"You don't have to book an appointment to ask us a question," she said. "You don't have to make an appointment, so we don't have as many barriers, I would say, to care as the other health professions might."

Empathy as the Foundation

Being available only helps if pharmacists care about the person in front of them, Houston said. She encouraged pharmacists to think of patients as family or as part of their community.

"My older patients might remind me of my grandparents," she said. "I think that's an important part of building rapport; building that relationship is first seeing people as human."

She also acknowledged the pressures of the job. "We all have businesses to run and we all have jobs to do, but at the end of the day, we are caring for people." She added pharmacists should take an interest in patients' lives and "become curious about maybe the way they're living or why they do certain things."

Houston said that, as a patient, she is "not really the best with adherence." What works best for her is keeping her medication where she can see it.

"If it's out on the counter, if it's out on your desk, you will see it and you will be reminded to take it," she said. Alarms and apps can help, but people often snooze or turn them off. "Whatever works for you, honestly, is the best."

A Patchwork of State Rules

Houston sees test-to-treat services as the biggest missed opportunity. Some pharmacists are pushing for the model, but many are not, she said, largely because many states lack the infrastructure to support it.

The rules vary by state. In some states, pharmacists can prescribe after a positive test. In others, they need a collaborative practice agreement with a provider, which usually covers patients the 2 share. Pharmacists can also connect patients to telehealth companies to get a prescription.

Houston said repeated COVID-19 waves make testing more important, especially when they overlap with flu season. "You have COVID[-19] and flu together, like a double hitter," she said. With the holidays coming, she noted that many people stopped testing after getting COVID-19 several times. "But then, how many people did you go around because you didn't test because you just didn't know?"

Now that the government no longer mails free tests to people's homes, Houston said, pharmacies could be the next accessible option for people who don't want to book an appointment or go to urgent care.

"How can pharmacists step up in the way that we stepped up with vaccines but also step up in this way for being able to test?” she asked.

She urged pharmacists to advocate for services "that we are able to do, but we might be prohibited to because of laws and different regulations."