Evaluation of a community pharmacy–based influenza and group A streptococcal pharyngitis disease management program using polymerase chain reaction point-of-care testing
| Autor: | Donald G. Klepser, Keith M. Olsen, Janice S. Murry, Michael E. Klepser, Hamilton Borden |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Oseltamivir Adolescent Streptococcus pyogenes Point-of-care testing MEDLINE Pharmacology (nursing) Pharmacy Community Pharmacy Services Pharmacists Antiviral Agents Polymerase Chain Reaction 030226 pharmacology & pharmacy Young Adult 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Streptococcal Infections Influenza Human medicine Humans 030212 general & internal medicine Disease management (health) Medical prescription Child Pharmacology business.industry Pharyngitis Middle Aged Amoxicillin Tennessee Anti-Bacterial Agents chemistry Point-of-Care Testing Child Preschool Emergency medicine Female medicine.symptom business medicine.drug |
| Zdroj: | Journal of the American Pharmacists Association. 59:872-879 |
| ISSN: | 1544-3191 |
| DOI: | 10.1016/j.japh.2019.07.011 |
| Popis: | Objectives The purpose of this study was to demonstrate the feasibility of implementing a Clinical Laboratory Improvement Amendments–waived real-time polymerase chain reaction (PCR) molecular test into a community pharmacy setting as part of a collaborative influenza and group A Streptococcus (GAS) disease management program. Setting and participants Two community pharmacy sites in Tennessee. Practice description Patients presenting to the pharmacy with symptoms consistent with influenza or GAS from November 1, 2016, to April 30, 2018. Practice innovation Influenza and GAS management programs based on previously developed protocols occurred at 2 community pharmacies in Tennessee. Pharmacies used the Cobas Liat testing system (Roche Diagnostics). Based on test results and under a collaborative practice agreement, pharmacists dispensed prescription medications for patients with a positive test: oseltamivir for influenza and amoxicillin for GAS. Patients with negative tests were treated with over-the-counter (OTC) medications or referred. Patients testing negative for GAS were asked to consent to having a second throat swab sent for culture. Evaluation Number of patients tested, point-of-care test results, and treatment received. Results Two hundred and two patients received care at the 2 pharmacies (116 for influenza, 46 for GAS, and 43 for both). Sixty (38%) tested positive for influenza, with 51 receiving an antiviral prescription, and 16 (18%) tested positive and were treated for GAS. No patient testing negative for either or positive for influenza was dispensed an antibiotic. For patients consenting to a follow-up culture, all GAS cultures sent for confirmatory testing were negative. Conclusion A protocol-driven community pharmacy–based disease management program using real-time PCR testing for influenza and GAS was able to offer appropriate treatment to patients without overuse of antibiotics. |
| Databáze: | OpenAIRE |
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