Expert: Pharmacy Profession Must Remain United on Retention of COVID-19 Regulatory Changes Post-Pandemic

The COVID-19 pandemic significantly impacted pharmacy practice due to its role in supporting overwhelmed physicians, nurses, and other health care professionals who faced some of the immediate challenges of the crisis, according to Hoai-An Truong, PharmD, MPH, FAPhA, FNAP, professor of pharmacy practice and administration at the University of Maryland Eastern Shore, during a session at the American Pharmacists Association 2021 Annual Meeting and Exposition.

For example, many states allowed pharmacies to conduct COVID-19 testing and other additional services in order to decrease the ongoing burden on physicians during the pandemic, Truong explained.

“COVID-19 provided pharmacy practice the opportunity to shine through identifying areas where [it] could offer much needed relief to the overwhelmed health care system,” Truong said during the session. “I like to frame it in the WHO approach, which is not the World Health Organization, but the why, how, and opportunity. Why is it a challenge on the health care system, how does it impact pharmacy practice, and what are some opportunities that present for us.”

Truong explained that using this WHO approach, his research team at the University of Maryland Eastern Shore was able to identify an opportunity to address a challenge to the health care system they observed by applying for funding from the Maryland Department of Health, as made available through the CARES Act, and implementing telehealth as an intervention for nursing home residents.

In this way, despite his background being in the community and ambulatory setting, Truong and his team took the opportunity to assess how pharmacy could support a challenge specific to nursing home facilities by providing access to telehealth.

“We know that was a population that was severely impacted by the pandemic due to social isolation. So, we were able to obtain a grant and conduct a project and research how to utilize telehealth to deliver non-pharmacological intervention, including patient education and music therapy for the nursing home residents in the rural area on the Eastern Shore of Maryland,” Truong said.

Apart from the pandemic’s extensive impact on health care systems, Truong also discussed some of the specific impacts the pandemic has had on pharmacy practice, from supply chain issues to changes in pharmacist’s services.

“COVID-19 will leave a lasting impression on pharmacies, [and] COVID-19 is likely to leave a lasting impression on the services provided by pharmacists,” Truong said during the session.

Supply chain issues, such as the shortages that occurred around albuterol and hydroxychloroquine, had a significant impact on pharmacy practice during the pandemic. Additionally, the increased practice of providing patients with 90-day supplies during the pandemic may have contributed to supply chain challenges around medication access for pharmacies.

The pandemic also forced pharmacies to quickly adapt their practices to allow for socially distant patient care, causing exponential telehealth growth in the field. In order to support audio and/or video connection with patients, many pharmacies had to learn how to quickly implement—what were for some—new telehealth applications. This required pharmacists to learn how to quickly overcome technology hurdles as they arose during the implementation and use of these applications.

“There has been exponential growth in the use of telehealth in patient care, but that also led to audio/video connection and technological issues,” Truong said during the session. “It also highlights the challenge of inequities in the country for those who do not have the technology means to receive the telehealth care that they need.”

Truong also discussed other areas of pharmacy practice that have been impacted by the pandemic, such as chaos emerging around pharmacy reimbursement and the slowing of the delivery of medicines due to US mail delays. This is in addition to the effect of needing to quickly immunize large communities for COVID-19 upon receipt of the vaccine and authorization to administer it.

However, Truong explained that there have also been some positive impacts from COVID-19 to pharmacy practice. For example, with more COVID-19 vaccines in more pharmacies, many pharmacies had to go on a hiring spree to meet the needs of the vaccination process. Additionally, another example can be seen in Massachusetts, where pharmacists were recognized as providers by the state on February 8, 2021.

Furthermore, the Federal Retail Pharmacy Program brought the importance of the pharmacy to the forefront of the US COVID-19 vaccine campaign, as the federal government through the program began to directly supply pharmacies with vaccine doses to administer to patients.

There remain further opportunities available for pharmacists to seize that support health systems during the pandemic, Truong noted. For example, with the Guidance for License Pharmacists, COVID-19 Testing, and Immunity under the PREP Act released on January 31, 2020, the Department of Health and Human Services detailed some specific ways that pharmacists could partner with other health care providers to assist in the expansion of COVID-19 testing.

“It is an opportunity for the pharmacy profession to shine and pursue additional opportunities,” Truong said.

Following the guidance released in January 2020, numerous other regulatory changes were made by the federal government to allow for further opportunities for pharmacies to support the testing and vaccination process during the pandemic, giving pharmacy an even greater role in supporting the health care system.

This has given rise to questions regarding whether such regulatory changes should be retained post-pandemic in order to cement pharmacy’s ability to continue to provide these additional services for communities.

“I think the key question and issue here is sustainability. We need to be united more than ever as a profession of pharmacy,” Truong said during the session. “It’s important that we remain together and be united to ensure that these regulatory changes for pharmacists are not only temporary during the pandemic, but will also be sustainable beyond the pandemic.”

REFERENCE

Truong HA, Thornton D. Colleagues in Research: Pharmacy Practice and Research Implications of COVID-19. APhA 2021 Annual Meeting and Exposition