Health & Medical Medications & Drugs

The Pharmacist Will Screen You Now

The Pharmacist Will Screen You Now

Rapid Diagnostic Tests in the Pharmacy


Although information garnered from rapid diagnostic tests (RDTs) and point-of-care CLIA-waived tests is valuable as a patient moves through the healthcare system, availability to pharmacists at the patient's first point of contact with the system could yield the maximum benefit to the patient. Pilot projects seeking to highlight the utility of RDTs in community pharmacy practices are currently underway in several states. In these projects, pharmacists are using CLIA-waived RDTs to identify patients with infections such as influenza, group A Streptococcus, HIV, and hepatitis C. For pathogens causing acute illness such as influenza or streptococcal pharyngitis, pharmacists screen symptomatic patients and perform an RDT on appropriate patients as determined by an algorithm. On the basis of the findings, pharmacists manage patients under a collaborative practice agreement with a partnering physician. This allows for appropriate patients to have antimicrobial therapy initiated in the pharmacy within minutes of presentation and for other patients to be referred to a provider when warranted.

For HIV and hepatitis C, pharmacists are able to screen asymptomatic patients with disease risk factors. Patients with reactive test results are then referred to public health departments or appropriate providers for disease verification and initiation of treatment. In both scenarios outlined here, the focus is on the rapid identification of patients with diseases of interest and referral to the healthcare system at the appropriate point to initiate therapy in a timely manner. It is believed that data generated through these initiatives will demonstrate that appropriately trained pharmacists can use RDTs to provide quick and accurate care resulting in a reduction in improper antimicrobial use and healthcare costs.

Although many current initiatives focus on identification and management of infectious diseases, CLIA-waived platforms exist that would provide pharmacists an opportunity to extend medication therapy management programs. Such platforms would provide the pharmacist with essential laboratory data about the patient's renal and hepatic function and serum chemistries. This information could be used to adjust the dosage of medications on the basis of therapeutic efficacy and side effects. Employing such technology could significantly improve the ability of pharmacists to influence patient outcomes and avoid medication misadventures.

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