14 clinical services pharmacists can provide when they have time with patients

The COVID-19 pandemic curbed patients’ doctor visits but has transformed their reliance on, and increased their visits to, the local pharmacy.


Pharmacy customers and staff alike can benefit when pharmacies are equipped to provide more clinical services on site – saving patients an extra trip to the doctor, making it easier for them to get what they need at lower-cost sites of care, and generating more revenue in the pharmacy.


Pharmacists are the most accessible healthcare providers. More than 90% of Americans live within five miles of a pharmacy. And, according to the Association of American Medical Colleges (AAMC), we’re anticipating a shortage of somewhere between 21,400 to 55,200 primary care physicians (PCPs) by 2033 in the US.


In England, the Pharmaceutical Services Negotiating Committee (PSNC) has reported seeing an increasing number of patient referrals to community pharmacies – saving an average of 94 general practitioner (GP) appointments per practice per week. More than 80% have been a result of patients self-referring to the pharmacy. The PSNC estimates that transferring 40 million GP appointments to pharmacies could save the country the equivalent of $771 million annually.


“Not only are more people attending a community pharmacy daily, seeking advice and support, but a higher percentage are self-referring,” the report says. We know the same is true in North America, and pharmacies have an opportunity to capitalize on that patient foot traffic, interest and advocacy.


In other words, when smart technologies like the scripClip™ will-call system improve operational efficiency, decrease customer wait times and free pharmacists to spend more time operating at the top of their licenses, everybody wins.

Here are a 14 healthcare services your customers may not have previously thought about getting at the pharmacy:

 

  1. Routine vaccinations
    Vaccinations may have been and continue to be the entry point for patients seeking clinical services, or any products or services, for that matter, at the pharmacy. Many acknowledge that COVID-19 vaccines and testing drove traffic and sales. From continued COVID-19 vaccines and boosters for all ages, to flu shots, to hepatitis A and B, HPV, MMR, meningitis, pneumonia, polio, shingles, Tdap and chickenpox, pharmacies can be the one-stop-shop for patients needing vaccines. View guidance in this Everyday Health article. Note that some states have limitations to what vaccinations pharmacies can offer.

  2. Travel vaccines and medications
    Vaccines also protect global travelers from diseases that may not normally be found in the US, such as yellow fever or typhoid. Travel health is a profitable and convenient way to expand immunization programs – especially as customers return to pre-pandemic rates of travel and tourism. Pharmacies garner a roughly $60 consultation fee, in addition to payment for the medications themselves. The CDC divides vaccines into three categories: routine (like those in #1 above), required and recommended. The International Society of Travel Medicine lets travelers search for clinicians online.

  3. Point-of-care (POC) testing
    Many Clinical Laboratory Improvement Amendments (CLIA)-waived tests can be provided in a pharmacy setting. Flu and strep tests are particularly convenient for patients to get at the local pharmacy, when they can’t necessarily count on telehealth or get an in-person appointment with their provider, and don’t want to overspend on urgent care or emergency care services. In states where pharmacies and physicians are able to have collaborative practice agreements (CPAs), patients can have antibiotics and antivirals prescribed and dispensed as soon as they test positive.

  4. Pre-exposure prophylaxis (PrEP) to prevent HIV infection
    PrEP is a daily pill with greater-than-90% efficacy in decreasing transmission of HIV and getting the US that much closer to ending the HIV endemic. Pharmacists can provide access to PrEP services in their pharmacies, including consultation, accountability for therapy adherence, and coordination with other health care providers. Programs like this are most valuable and lucrative in areas with high incidence of HIV. Several pharmacists weighed in on a Drug Topics article in June. Anthony Minniti, RPh, contributed and also spoke with PioneerRx leaders on a Catalyst Pharmacy podcast about the impact of Bell Pharmacy’s on-site PrEP clinic in Camden, NJ.

  5. Diabetes management and prediabetes consultation
    Diabetes affects more than 11% of Americans (37.3M in 2019; 8.5M of whom are undiagnosed). Being among the most accessible health care providers, pharmacists are able to provide screening and counseling about how to monitor and manage glucose levels. Most pharmacies already offer diabetes testing supplies (DTS) and, of course, insulin. According to the NCPA, pharmacists may also provide ancillary services such as diabetes self-management education/training (DSME/T) programs, therapeutic shoes and inserts, or conversation with prediabetic patients about making lifestyle changes. In May 2022, Drug Topics published this guide for launching HbA1c POC testing.

  6. Smoking cessation
    Because customers come to the pharmacy as part of their daily lives, there’s a chance staff will see them smoking if it’s a habit of theirs. Thus, pharmacies are uniquely positioned to squash one of the leading causes of preventable deaths by pulling tobacco products from shelves and offering approachable smoking cessation counseling, discussing over-the-counter (OTC) tobacco cessation options and, in some states, prescribing additional nicotine replacement therapy aids.

  7. Weight loss management
    According to the CDC, 74% of American adults are overweight. About one in three have metabolic syndrome, clustering a number of health conditions that increase risk of heart disease, type 2 diabetes and stroke, including high blood sugar, abnormal cholesterol and/or triglyceride levels, and high blood pressure. Pharmacies can provide accessible, medically sound solutions to help patients lose weight and improve their overall health. Programs may include things like 1:1 counseling, group activities (such as fitness tips, stress management techniques or cooking demonstrations) and weight-loss drug management. Drug Topics consulted with several pharmacists on how they constructed such programs.

  8. Birth control prescriptions
    In some states, oral contraceptives can also be prescribed in the pharmacy. “The role of pharmacists in family planning services is exploding,” writes birthcontrolpharmacist.com. Their downloadable fact sheet provides an overview of the birth-control prescription process, current state laws and outcomes, patient benefits, recommended preventive health screenings for women and other key things for both patients and providers to know. Some are also making strides to make birth control available OTC in the US, like 100+ countries around the world.

  9. Pharmacogenetic testing
    Genetic differences in drug metabolism may impact the drug or dosage a patient should be taking. Pharmacists’ specialized training in pharmacokinetics and visibility into social determinants of health (SDOH) make them an ideal partner in understanding why someone may or may not be responding well to certain medications by conducting screening, talking with the patient and sharing recommendations with the prescriber. Pharmacogenetic testing is relatively cutting edge and expected to increase in popularity; building the practice now could manifest substantial pharmacy growth.

  10. Medication therapy management (MTM)
    Medication-related problems and mismanagement result in an estimated 1.5 million preventable adverse events each year in the US. Pharmacists can provide MTM in any setting where patients may take medications, including prescription drugs, OTC meds and vitamins, minerals or supplements – helping ensure the meds are right for their health conditions and drive the intended outcomes. MTM is especially valuable for those patients who have several conditions, take multiple medications (from one or multiple pharmacies) and require close monitoring. MTM is comprised of five core components, as spelled out by the American Pharmacists Association (APhA): medication therapy review (MTR), personal medication record (PMR), medication-related action plan (MAP), intervention and/or referral, and documentation and follow-up.

  11. Long-acting injectable drugs
    In some states (44, as of 2019, according to Pharmacy Times), pharmacists are allowed to administer intramuscular and subcutaneous long-acting injectable antipsychotic (LAIA) and other medication injections, under CPAs with mental health practitioners and/or partnerships with drug manufacturers.

  12. Naloxone
    Naloxone is an FDA-approved medication designed to rapidly treat an narcotic overdose in emergency situations. Administered via intranasal spray or intramuscular, subcutaneous or intravenous injection, it temporarily blocks effects of opioids, such as heroin, morphine and oxycodone. Because opioid overdoses are life threatening and require immediate medical attention, pharmacies may be the most convenient and life-saving option in many cases.

  13. OTC vitamin, mineral and supplement (VMS) consultations
    Patients frequently want guidance in choosing what OTC herbals and supplements they should take. And pharmacies can realize substantial margins by keeping them in stock. Pharmacists are also uniquely positioned to offer depletion counseling when patients are prescribed other medications. For example, because amoxicillin can cause gut issues, providers may recommend a particular probiotic be taken in conjunction with the antibiotic.

  14. Paxlovid prescriptions
    As of July 6, 2022, the US Food and Drug Administration (FDA) authorized state-licensed pharmacists to prescribe Paxlovid to eligible patients. Patients are encouraged to seek care from their regular providers or local test-to-treat sites upon testing positive for COVID-19. “The FDA recognizes the important role pharmacists have played and continue to play in combatting this pandemic,” said Patrizia Cavazzoni, M.D., director for the FDA’s Center for Drug Evaluation and Research. Test to treat comes with a host of challenges but opens the door to better patient outcomes and new sources of revenue.

Start saving time and money with scripClip, so you can look at opportunities like these to create more fulfilling, life-saving and profitable work for your pharmacy team. Our communities – including employees, consumers, caregivers, fellow healthcare providers and payors – all benefit from embracing the industry shift to lower-cost, highly accessible sites of care. Especially pharmacies.

Be sure to consult with other clinical experts and familiarize yourself with state regulations and other local providers’ practices before pursuing any new initiatives. Only take on additional services that interest you, your staff and your patient population.

 

If you would like to speak with an experienced pharmacy expert at InterLink AI, contact us; we’re here to help!

14 clinical services to consider in the pharmacy