Effectiveness of a pharmacist-physician collaborative program to manage influenza-like illness

The pharmacist-physician relationship is crucial to the collaborative efforts towards providing the best patient care as soon as possible.  This study is a prospective multicenter cohort study in which pharmacists working under collaborative practice agreements (CPAs) with a licensed physicians were able to administer simple physicals, and point of care rapid influenza diagnostic tests.  There were six overseeing physicians that signed the collaborative practice agreement, and fifty five pharmacies (both chain and independent) in Minnesota, Michigan, and Nebraska that volunteered to be a part of the study.  Those adult patients who showed signs of influenza like illness, and did not have an excluding condition were able to get screened.

There were 121 patients that volunteered for this study, but 45 were excluded due to predetermined exclusion factors.  Of the 76 patients eligible, one was sent to emergency care due to a systolic blood pressure of 83 mmHg.  Only 5 patients at CPA sites tested positive for influenza like illness, and they were given oseltamivir.  After treatment, 78% of all patients in the study were contacted within 48 hours, and reported feeling better.  A large third-party payer was found saying that treatment for upper respiratory tract infections at a physician’s office is on average $130-$180 whereas for emergency care treatment the cost is closer to $510-$635.  One important finding is that 35% of the patients in the study reported not having a primary care provider.

The study mentions that factors such as inconvenience, cost, and treatment delays add to a patient’s dissatisfaction with the health care system.  In the study the average time a pharmacist spent per patient was 10 minutes with a follow-up phone call lasting less than 2 minutes.  It also states that under this CPA model, the pharmacists were able to avoid the patient pressures for prescriptions that physicians often encounter.  The pharmacists were recorded saying that they felt they were able to better guide patients toward effective OTC medications instead of unnecessary prescriptions.  The final conclusion drawn from this study was that more exploration of collaborative models is warranted.

As a patient, would you feel comfortable seeing a pharmacist for treatment of what you believe to be the flu?  How would collaborative practice agreements impact the physician-pharmacist relationship?  Do you feel that a community pharmacist would be able to add this additional service to their day, or what changes to the current community setting would need to be implemented?

J Am Pharm Assoc. 2016;56(1);14-21. 

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