Health Care Shortage Calls for Diversifying the Role of Community Pharmacists in Treatment of Minor Ailments

The United States currently faces a growing need for health care services with widening shortages of primary care physicians (PCP), leading to unmet office visits and increased reliance on emergency departments (ED). A new study explores the expanded opportunities for community pharmacists and the potential for diversifying their roles beyond medication dispensing, allowing them to treat patients with minor ailments.

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The study was conducted by a group of researchers from multiple universities, including Washington State University College of Pharmacy and Pharmaceutical Sciences; Idaho State University College of Pharmacy, Anchorage Campus; Washington State University School of Economic Sciences; and Washington State University Department of Mathematics.² Over a 3-year period, the study authors collected data from 46 pharmacies and 175 pharmacists to compare the cost and quality of care provided by community pharmacists for minor ailments to traditional health care settings.¹

The study collected data from 3 traditional health care settings: PCPs, urgent care centers, and EDs. Information collected from patients involved monthly pharmacy visits, patient demographics, insurance status, health history, treatment information, and 30-day follow up calls to assess outcomes. Quality and cost data collected from investigations into traditional health care settings were then compared with data collected from community pharmacy patient visits.¹

To determine the cost effectiveness and quality of treatment in community pharmacy settings, each pharmacy set an out-of-pocket cost for several common conditions—including urinary tract infections (UTIs), hormonal contraception, asthma, allergies, and headaches—so that patient insurance was not billed. These minor ailments represented the most common health concerns and treatments sought out by patients, as well as treatments that are significantly more affordable without insurance. Both mean and median costs per condition were calculated.¹

Revisit data were collected through 30-day follow ups with community pharmacy patients via phone calls conducted by the study authors, relying on patient reported information. These data encompassed the timing and location of revisit care, as well as whether symptoms were resolved post-treatment. Patient costs of care were calculated by comparing median costs from traditional care sites (PCPs, urgent care, EDs) to the original pharmacy cost. To assess quality of care, the research team used a noninferiority test with an equivalence margin of 20% to measure revisit proportions between care sites. Confidence intervals on this difference were established using Wilson intervals, and noninferiority testing was conducted with a 1–2α confidence interval at an α level of 0.05.¹ 

In traditional health care sites, study authors measured cost and quality of care using data from patients’ health insurance claims, excluding individuals under 18 years of age. Diagnostic codes for common ailments relevant to the study (ie, UTIs, common cold, contraceptives) were categorized from health insurance claims and grouped to represent specific ailments.¹

When measuring data from revisits, study authors defined revisits based on their occurrence and the condition being treated. These visits were analyzed using 2 methods: superiority (which compared traditional care sites and community pharmacies) and noninferiority (which assessed whether pharmacy care was as effective as traditional site of care). Data were collected every 4 weeks over a 3 year period.¹

The research team found that treatment by pharmacists for patients with minor ailments was statistically less costly compared to care from traditional sites. Using a median cost difference of $277.78, they found that if patients who were treated at a community pharmacy had sought care from traditional sites, the additional cost to the health care system would have been approximately $138,000. If patients initially receiving care from traditional facilities had sought out care from pharmacies, the cost savings would have been approximately $23,500,000.¹

The demonstrated cost savings associated with receiving care at community pharmacies, as opposed to traditional health care settings, underscore the potential benefits of utilizing pharmacies as readily accessible and efficient avenues for addressing minor ailments. In this way, diversifying pharmacists’ roles opens avenues for patients to access treatment that is both timely and cost-effective.

“Overall, this research showed both feasibility and significant patient and public health cost savings when care was provided by a community pharmacist as compared to providers at traditional sites of care,” study authors concluded. “Research findings support nationwide replication of this model of pharmacist-provided patient care resulting in increased access to healthcare for patients, particularly in rural and underserved areas.”¹

REFERENCES

1. Akers JM, Miller JC, Seignemartin B, MacLean LG, Mandal B, Kogan C. Expanding Access to Patient Care in Community Pharmacies for Minor Illnesses in Washington State. Clinicoecon Outcomes Res. 2024;16:233-246. doi:10.2147/CEOR.S452743

2. University Research Finds Pharmacies Are Most Cost-Effective Options for Patients with Minor Ailments. NACDS Foundation. May 16, 2024. Accessed May 17, 2024. https://media.jamanetwork.com/news-item/changes-in-life-expectancy-after-allogeneic-blood-or-marrow-transplantation/