Role of pharmacist-provided point-of-care testing

Abstract

APhA–APPM Patient care opportunities for pharmacists with point-of-care testing P o i n t o f c a r e (POC) testing, or “diagnostic testing performed at or near the site of patient care,” is a convenient, affordable, and reliable method for pharmacists to measure laboratory values.1,2 Currently, more than 120 POC tests waived under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) are available for use in the evaluation and management of many acute and chronic diseases.3 Pharmacists can provide these tests to patients as alternative, accessible, and impactful health care options. With more than 8 million Americans having undiagnosed diabetes and more than 35 million having uncontrolled blood pressure, pharmacists have the opportunity to play a critical role in patient care through the provision of POC testing.4,5 Blood glucose and blood pressure screenings are just two of the simple POC tests that pharmacists can provide to screen for common chronic diseases, and such tests are often provided as complementary services in the community. The addition of lipid screenings and extensive counseling present both a clinical and business opportunity for pharmacists. In general, POC test screening results may serve as a preliminary means for screening for chronic disease states and potential diagnoses. POC testing may also serve as a valuable tool for pharmacist-provided disease state management of patients diagnosed with chronic disease(s). Convenient, inexpensive, and quick POC tests enable pharmacists to deliver necessary recommendations and interventions to help patients manage their disease states in a timely and convenient manner. Common POC tests used for disease state management include glycosylated hemoglobin (A1C) and blood glucose screenings for diabetes, blood pressure measurement for hypertension, lipid panel testing for cardiovascular disease, and prothrombin time (PT)/international normalized ratio (INR) testing for anticoagulation monitoring. While communication of recommendations to physicians can be a barrier, many states allow pharmacists to practice collaborative drug therapy management (CDTM).6 POC testing is most often associated with chronic disease screening and management, but a rapidly growing area is POC testing for inRole of pharmacist-provided point-of-care testing