Pharmacist Prescribing: “Test and Treat”

There has been a growing interest in pharmacist prescribing based on the results of a rapid diagnostic test for strep or flu.

Current Landscape:

• Idaho pharmacists are allowed to prescribe products to treat strep/flu pursuant to a rapid diagnostic test. There is NO state-mandated protocol but pharmacies must develop and utilize an evidence-based protocol. The regulations went into effect in the summer of 2018.
  • The Idaho Board of Pharmacy also convened stakeholders to develop sample protocols for pharmacies to use. These may be very helpful to use as an example: Access them here.
• Kentucky’s Board of Pharmacy has approved what they call statewide protocols that include strep and flu. Because their authority requires a doctor to sign off on a pharmacist using the protocol, it’s actually more of a collaborative practice authority than a true statewide protocol.
  • You can look at their specific protocols as another example.
• Florida recently passed a law allowing pharmacists to test and treat for minor, nonchronic conditions (including strep and flu) under a protocol with a physician. Florida HB 389 (2020)
• Beyond statewide authority, many states have CPA authority broad enough to allow pharmacists to prescribe pursuant to a rapid diagnostic test. Based on NASPA’s research, these states include:
  • ID, IL, MI, MN, MT, NE, NM, ND, SD, TN, UT, VT, WA, WI
    • If your state should or should not be included on this list, please email comment on this page below.
  • Example protocols used for CPAs

Research Articles:

• Utilization of influenza and streptococcal pharyngitis point-of-care testing in the community pharmacy setting
• A community pharmacy-based influenza screening and management program shortens time to treatment versus pharmacy screening with referral to standard of care
• Time and motion study of influenza diagnostic testing in a community pharmacy
• Effectiveness of a pharmacist-physician collaborative program to manage influenza-like illness
• Community pharmacist-physician collaborative streptococcal pharyngitis management program
• A feasibility service evaluation of screening and treatment of group A streptococcal pharyngitis in community pharmacies
•  Pharmacy-based management of influenza: lessons learned from research

Advocacy Resources:
If your state needs a similar advocacy resource, please reach out!

• Texas One-Pager
• Colorado One-Pager
• Arizona One-Pager (includes more than strep/flu)

Other Resources:

• Implementation guide from the Community Pharmacy Foundation and Washington State University

 

Click Here to Go to the Pharmacist Prescribing Resource Page