Community Pharmacies Well-Situated to Offer Point-of-Care Infectious Disease Testing

By offering quick and convenient tests for diseases such as influenza, HIV, and hepatitis C, community pharmacies could help improve prevention and treatment.

Point-of-care testing for infectious diseases may provide an opportunity for community pharmacies to expand patient care services while improving health at the patient and population level, suggest the authors of an article published in the March/April 2014 issue of the Journal of the American Pharmacists Association.

Point-of-care testing, which is designed to be convenient and fast for patients, can improve the prevention and treatment of infectious diseases such as influenza, group A streptococcal pharyngitis, HIV, and hepatitis C. Community pharmacies, the authors argue, may be an ideal setting for such tests.

The authors performed a literature review and researched state pharmacy laws to identify opportunities for and potential barriers to offering point-of-care testing for infectious diseases at community pharmacies. They found that the skills and accessibility of community pharmacists, as well as evidence indicating that pharmacists can significantly improve prevention and management of infectious diseases, place them in a unique position to improve patient outcomes through point-of-care testing. In addition, availability of testing at pharmacies could help decrease inappropriate treatment with antibiotics, reduce the spread of infectious disease, and improve disease monitoring, the authors suggest.

Testing for infectious diseases in community pharmacies can also be used to screen patients at risk for communicable diseases, which could improve linkage to care and “may also provide more accurate data on disease prevalence as well as increase public health agencies’ ability to reach targeted populations for screening,” the authors note.

Offering point-of-care testing may also bring benefits to pharmacies. In the past decade, the number of pharmacies with a certificate to offer services waived under the Clinical Laboratory Improvement Amendments of 1988, including point-of-care testing, has nearly tripled. Although the reasons for this increase have not been investigated, the authors speculate that the growth may be driven by a desire to enhance revenue and patient services and gain a competitive edge in the shifting health care landscape.

Despite the potential benefits of point-of-care testing for infectious disease, the authors identified several barriers that may prevent some pharmacies from offering these services. Regulations concerning the testing vary from state to state and are often vague. Only 8 states explicitly address point-of-care testing in their pharmacy practice acts, and 5 of these specify which tests pharmacists are allowed to perform. Lack of education and training regarding proper testing techniques may also limit pharmacies’ ability to offer the services.

However, the authors argue that these obstacles can be overcome, with potential benefits for both patients and community pharmacies.

“Challenges to the implementation of [point-of-care] testing for infectious diseases are not insurmountable if pharmacists obtain the proper training, understand their state regulations and statutes, and work with regulators and stakeholders to ensure such services and follow-up care are provided legally, safely, accurately, and efficiently,” the authors argue. “[Point-of-care] testing for infectious diseases has many potential patient and population level benefits and could expand community pharmacy’s patient care service offerings.”