Point-of-Care Cognitive Screenings Present Opportunities

According to a 2020 LANCET commission, 12 modifiable factors account for 40% of the risk of developing dementia.¹ Individuals at increased risk include those who are overweight, have diabetes or hypertension, or lead a sedentary life. Most, however, do not have access to routine cognitive screening. That is where community pharmacies come in.

Credit: Dr_Microbe - Austria - stock.adobe.com.

These screenings, which measure attention, executive function, and memory, are often limited because they rely on paper-and-pencil tests. However, Cognivue Thrive (www.cognivue.com) is a new, clinically validated, computerized cognitive assessment device based on FDA-cleared technology. In just 5 minutes, it produces a report on executive function, memory, visuospatial domains, processing speed, and reaction time, giving a baseline snapshot of how a patient’s brain is functioning.²

Community pharmacies that undertake cognitive screenings benefit from the following:

• Convenience. Patients visit pharmacies more frequently than primary care offices and can be screened without having to schedule a doctor’s appointment or go to a separate testing facility.
• Early detection. Cognitive impairment can be an early sign of dementia or other neurological disorders. Dementia can take decades to manifest, so early assessment is key. By offering convenient screenings, pharmacists can assess brain health and promote earlier interventions, which may slow or even reverse the impairment.
• Objective results. Tools like Cognivue Thrive eliminate health care provider bias and offer consistent, reliable results.²
• Patient engagement. By engaging patients in the testing process, pharmacists can help them better understand the modifiable risk factors that affect cognitive function. When patients are engaged in their health care, they are more likely to adhere to treatment plans and make lifestyle changes to improve their overall health.
• Referrals. A cognitive screening report is routinely provided to the patient’s primary care physician and could lead to increased doctor referrals to pharmacies of patients who may be good candidates for screening.
• Revenue. Community pharmacies’ revenue from the dispensing of medications has been under increased pressure from payer-imposed contracts as well as direct and indirect renumeration fees. Many independent pharmacies are concerned about the January 2024 changes to these fees, which will be collected at the point of sale³ and will represent a cash flow challenge for those that rely heavily on dispensing revenue. Cognitive screenings at the point of care would provide community pharmacies a new, nondispensing revenue stream. In addition, having a baseline report will allow pharmacies to schedule follow-up screenings and recommend protocols that may include treatment.
• Workflow. By offering a wider range of clinical services, pharmacies can attract more patients, increase revenue, reduce the burden on primary care physicians, and free up resources for other health care services.

According to the Alzheimer’s Association, more than 6 million Americans have the disease, including 10.7% of individuals 65 years and older, and by 2050, 12.7 million Americans are projected to have it.⁴

As the demand for cognitive screenings continues to rise, pharmacies are uniquely positioned to provide this valuable service to their communities.

References

1. Livingston G, Huntley J, Sommerland A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10284):413-446. doi:10.1016/S0140-6736(20)30367-6

2. Cognivue. Accessed April 11, 2023. https://www.cognivue.com/

3. DIR rule changes in 2024: what’s coming and how to avoid a cash flow crunch. RxSafe. February 1, 2023. Accessed April 11, 2023. https://info.rxsafe.com/blog/dir-rule-changes-in-2024-whats-coming-and-how-to-avoid-a-cash-flow-crunch#:~:text=CMS%20will%20remove%20retroactive%20application,costs%20for%20patients%20and%20pharmacies

4. Alzheimer’s Association. 2023 Alzheimer’s disease facts and figures. Alzheimers Dement. 2023;19(4). doi:10.1002/alz.13016

About the Author

Ned Milenkovich, PharmD, JD, is principal and health care chair at Much, a law firm in Chicago, Illinois.