Community pharmacist–physician collaborative streptococcal pharyngitis management program

Abstract

ObjectivesTo describe patient outcomes associated with a community pharmacy–based, collaborative physician-pharmacist group A Streptococcus (GAS) management program. SettingFifty-five chain and independent community pharmacies in Michigan, Minnesota, and Nebraska. Practice innovationPharmacists screened clinically stable adult patients who presented with signs and symptoms consistent with GAS pharyngitis from October 1, 2013, to August 1, 2014, by means of Centor criteria, and performed a physical assessment followed by a rapid antigen detection test (RADT) for eligible patients. Patients were treated according to a collaborative practice agreement (CPA) with a licensed prescriber or a physician consult site model. Pharmacists followed up with patients 24–48 hours after the encounter to assess patient status and possible need for further intervention. EvaluationNumber of patients screened, tested, and treated, and health care utilization. ResultsOf 316 patients screened, 43 (13.6%) were excluded and referred for care. Of 273 patients (86.4%) eligible for testing, 48 (17.6%) had positive test results and 46 (16.8%) received amoxicillin or azithromycin per the CPA. Of those tested, 43.2% had no primary provider and 43.9% visited the pharmacy outside of traditional clinic office hours. ConclusionPharmacists demonstrated the ability and capacity to provide care for patients seeking treatment for pharyngitis. The number of patients without a primary care provider and seen at the pharmacy outside of normal office hours highlights the improved access that community pharmacy–based care offers.