Corn Carolyn E, Klepser Donald G, Dering-Anderson Allison M, Brown Terrence G, Klepser Michael E, Smith Jaclyn K
1 Outpatient Specialty Pharmacy, Nebraska Medicine, Omaha, NE, USA.
2 College of Pharmacy (Pharmacy Practice), University of Nebraska Medical Center, Omaha, NE, USA.
J Pharm Pract. 2018 Jun;31(3):284-291. doi: 10.1177/0897190017710518. Epub 2017 May 28.
Acute pharyngitis is among the most common infectious diseases encountered in the United States, resulting in 13 million patient visits annually, with group A streptococcus (GAS) being a common causative pathogen. It is estimated that annual expenditures for the treatment of adult pharyngitis will exceed US$1.2 billion annually. This substantial projection reinforces the need to evaluate diagnosis and treatment of adult pharyngitis in nontraditional settings.
The objective of this research is to quantify the amount of pharmacist time required to complete a point-of-care (POC) test for a patient presenting with pharyngitis symptoms.
A standardized patient with pharyngitis symptoms visited 11 pharmacies for POC testing services for a total of 33 patient encounters. An observer was present at each encounter and recorded the total encounter time, divided into 9 categories. Pharmacists conducted POC testing in 1 of 2 ways: sequence 1-pharmacists performed all service-related tasks; sequence 2-both pharmacists and pharmacist interns performed service-related tasks.
The average time for completion of a POC test for GAS pharyngitis was 25.3 ± 4.8 minutes. The average pharmacist participation time per encounter was 12.7 ± 3.0 minutes (sequence 1), which decreased to 2.6 ± 1.1 minutes when pharmacist interns were involved in the testing (sequence 2).
Although additional studies are required to further assess service feasibility, this study indicates that a GAS POC testing service could be implemented in a community pharmacy with limited disruption or change to workflow and staff.
急性咽炎是美国最常见的传染病之一，每年导致1300万人次就诊，A组链球菌（GAS）是常见的致病病原体。据估计，每年用于治疗成人咽炎的费用将超过12亿美元。这一巨大的预测强化了在非传统环境中评估成人咽炎诊断和治疗的必要性。
本研究的目的是量化为出现咽炎症状的患者完成即时检验（POC）所需药剂师的时间量。
一名有咽炎症状的标准化患者前往11家药店进行POC检测服务，共进行了33次患者问诊。每次问诊都有一名观察员在场，并记录总问诊时间，分为9类。药剂师通过以下两种方式之一进行POC检测：顺序1-药剂师执行所有与服务相关的任务；顺序2-药剂师和药剂师实习生都执行与服务相关的任务。
GAS咽炎POC检测的平均完成时间为25.3±4.8分钟。每次问诊药剂师的平均参与时间为12.7±3.0分钟（顺序1），当药剂师实习生参与检测时（顺序2），该时间降至2.6±1.1分钟。
尽管需要进一步的研究来进一步评估服务的可行性，但本研究表明，GAS POC检测服务可以在社区药店实施，对工作流程和人员的干扰或改变有限。
