Point of care testing in community pharmacy practice

Abstract

Community pharmacists are accessible health professionals who play a key role in the prevention and management of non-communicable diseases (NCDs). Point-of-care testing (POCT) service provision by community pharmacists has the potential to facilitate pharmacist intervention with respect to NCDs. The aim of this research was to assess the feasibility and impact of POCT offered in community pharmacies for NCDs. The objective was to develop a framework for a collaborative care model to ensure consistency and standardisation in the provision of POCT services by community pharmacists. A POCT service covering blood glucose, total cholesterol and triglycerides, blood pressure and body composition measurement was planned. A framework was developed and validated. A document was prepared and used to ensure standardisation and consistency by community pharmacists in offering the POCT service, and reliability, practicality, and feasibility in compiling the data collection sheet and of the testing process were established. The POCT service was implemented on 80 patients identified by convenience sampling from 4 community pharmacies. Test results were interpreted and an action plan for each patient was developed (t1). The action plan reflecting test results consisted of: lifestyle advice, referral to general practitioner (GP), referral to emergency department, and retesting at three (t3) and six (t6) months. Of the 80 patients, 43 were female, mean age was 60 years (range 19-85 years) and patients were taking a mean of 2 medications daily (range 1-6 medications daily). At t1, all patients were offered lifestyle advice, patients were referred to a GP due to out-of-range blood pressure (n=17), out-of-range blood pressure and fasting blood glucose (n=4) or due to elevated fasting blood glucose levels (n=2). Of the latter, 2 patients were started on antidiabetic treatment by the GP. Of the 80 patients, 56 patients were asked to retest at t3 and 24 patients at t6. At t3, 23 patients were tested and a statistically significant improvement (p<0.05) was observed through reduction in the level of systolic blood pressure (n=11), total cholesterol (n=9) and fasting blood glucose (n=6). At t6, 10 patients were tested, maintaining all parameters within range. The outcome of this study was the development of a framework to ensure standardisation and consistency in the provision of POCT services by community pharmacists. The results indicate that provision of blood pressure, blood glucose and lipid profile POCT in community pharmacies is feasible and effective since improvement in test parameters at follow-up was observed.