Urgent Care
Maria G. Tanzi, PharmD
Community pharmacists’ scope of practice is widening during COVID-19, with more patients seeking care from pharmacists and more pharmacies anticipating increased point-of-care testing and expanded immunization services.
“We are getting more OTC questions than any other time in my 27 years as a pharmacist,” said Nadia Rasul, RPh, from Kroger Pharmacy in the Columbus, OH, area. She noted that community pharmacists are the new urgent care professional when patients are afraid to go to medical offices.
“We counsel on which gauze to get, how to change a dressing, how to help a breastfeeding mom know if her symptoms are serious enough to go to the emergency department—and we help calm anxiety about COVID-19,” she said. “We also address concerns about buying ibuprofen after listening to the media, how to take a temperature. And we explain how soap is still a viable option when no sanitizer is available.”
NCPA survey
A recent survey from the National Community Pharmacists Association (NCPA) highlights how the COVID-19 pandemic is changing community pharmacy practice. It was sent to 8,000 pharmacy owners and managers from May 18–25 and was completed by 315 participants.
The respondents noted the pandemic may result in more pharmacies offering point-of-care testing (61.3%) and immunizations (52.1%), and more pharmacies seeing a scope of practice expansion (56.9%). The majority (61.0%) also said the pandemic will result in an increased consumer demand for online products and availability.
In terms of operational changes during the pandemic, respondents said they have increased curbside delivery or expanded delivery services (82.4%) and have increased their online presence or social media advertising (37.5%) in recent months. Respondents also noted these changes are expected to continue even after the pandemic subsides. The pharmacy staff’s use of personal protective equipment such as masks and gloves will remain as well.
NCPA also asked survey participants what initiatives would be most helpful with the integration of additional services at the community pharmacy. Of the respondents, 78.7% said “how to” guides would be useful; 72.6% wanted peer best practices; 67.6% desired resources to train the staff; and 50.3% asked for workflow integration guides.
The full survey results can be found at www.apha.us/NCPAsurvey.
Expanding patient care
Community pharmacies are an essential service and have remained open during the pandemic to provide care to patients. Local pharmacies are often the initial place many patients call or visit when they are not feeling well. Patient–pharmacist interactions have increased during the pandemic, which presents an opportunity for community pharmacists to further impact patient care.
Pharmacists can provide accurate and real-time information on COVID-19 and have a direct role in combating misinformation and helping patients understand the evidence for various treatments. Pharmacists can also help with OTC product selections as well as offer advice and reinforce messages about hand and respiratory hygiene and physical distancing. Increased interactions allow the pharmacist to assess a patient’s immunization status, administer recommended vaccines, and conduct point-of-care testing, if available.
Pharmacists may be the first point of contact for those experiencing mental health issues and are well positioned to offer advice on limiting sources of stress, managing feelings of isolation, providing evidence-based information and advice on maintaining routines, and referring patients to other health care providers when needed. During times of stress, patients who use tobacco products may be experiencing increased use, and those who quit in the past may find themselves using them again. The patient–pharmacist interaction is yet another opportunity to screen patients for tobacco use and implement smoking cessation interventions to help patients quit.
The increased availability of virtual and telephone consultations is also useful, especially for vulnerable populations who are sheltering in place. Expansion of services such as delivery and curbside pickup will help ensure adherence with prescribed therapies is maintained for those who cannot visit the pharmacy.