Look for Expanding Pharmacist Roles With Point-of-Care Testing

Point-of-care testing for flu, strep, and other infections will gain more traction...as pharmacist roles continue to expand.

This trend helps promote antimicrobial stewardship...detect conditions early...and may reduce ED visits and hospitalizations.

Pharmacists providing this service can rule out the need for antibiotics or antivirals...or furnish Rxs under collaborative agreements. And more states will allow this under a protocol, standing order, etc.

But ensure you have a way to act on results BEFORE you test.

Think of integrating point-of-care tests into your workflow as being similar to immunizations. It's another way to improve patient care.

Follow your state laws and pharmacy policies to find out what training or certification you'll need to get started.

Assess whether the test is needed based on symptoms, duration, etc.

Explain testing usually isn't covered by payers, but may be less costly and more convenient than an office or urgent care visit.

Use a team approach. For example, techs can gather patient history, consent, etc...and set up supplies (throat or nasal swab, etc). Help them get involved with our Point-of-Care Testing: Technician Checklist.

Evaluate symptoms AND test results...and if appropriate, furnish meds using your protocol. For example, consider oseltamivir 75 mg BID for 5 days for high-risk adults (over age 65, etc) with a positive flu test and symptoms...so they can start the med ASAP. False positives are rare.

But don't rely on negative test results alone. Promptly refer patients with "red flag" symptoms (high temp, etc) for further evaluation.

Follow up with patients in a couple days regardless of test outcome to ensure symptoms have resolved...or they've connected to a referral.

See our chart, Point-of-Care Testing, for A1C, hep C, HIV, and other tests...and specifics on administering and interpreting results.

Key References

  • J Am Pharm Assoc (2003) 2016;56(3):323-329.e1
  • J Am Pharm Assoc (2003) Published online Aug 29, 2019; doi:10.1016/j.japh.2019.07.011
  • www.cdc.gov/flu/professionals/diagnosis/rapidclin.htm#Table1 (11-11-19)
  • Clin Infect Dis 2012;55(10):e86-e102
Pharmacist's Letter. December 2019, No. 351205

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