Pharmacists Perceptions of Providing Colorectal Cancer Screening in Community-Based Practice.

BACKGROUND: Colorectal cancer (CRC) is the third most common diagnosed cancer in the United States. Kentucky pharmacists can be instrumental in the CRC early detection process through board authorized protocols (BAP): a regulatory approach managed by the Kentucky Board of Pharmacy that allows pharmacists to increase access to care while saving lives through early detection screening. Determining the barriers and successes of implementing CRC screening can improve access to education and care for patients. OBJECTIVE(S): This study aims to evaluate community pharmacists' perceptions of implementing a colorectal screening for patients via protocol and identify pharmacists' confidence and potential barriers such as cost, staff support, and patient need for colorectal screening in community pharmacy settings. METHODS: A survey was sent electronically to a convenience sample of pharmacists throughout Kentucky. The survey collected demographics, opinions regarding implementation of the colorectal cancer screening protocol, pharmacists' perceptions of knowledge, as well as the barriers and benefits associated with implementation of CRC services. RESULTS: 207 responses were received and of those 151 were from community-based pharmacists. 34% of pharmacists agreed or strongly agreed to offer CRC screening. Overwhelmingly, 81.3% of pharmacists reported need for additional training. There were no statistically significant differences in support among demographic factors; practice setting (p-value = 0.937), gender (p-value = 0.973), age (p-value = 0.568), years practicing (p-value = 0.870). In addition, the most common barriers reported were lack of reimbursement (97%), lack of willingness for patients to pay (98%), and time or workflow issues (97%). Most pharmacists stated that lack of trust in pharmacists was not a barrier (87%). CONCLUSIONS: Overall, 34% of pharmacists either agreed or strongly agreed to offer colorectal cancer screening via the board-approved protocol. However, overwhelmingly the pharmacists believe that there is a need for additional training and opportunities for additional training on board authorized protocols have increased drastically in Kentucky. Barriers such as lack of reimbursement, willingness to pay, and time or workflow issues are barriers that need to be overcome before implementation. Finding solutions to these barriers will increase pharmacist's support.

Patient awareness, willingness, and barriers to point-of-care hepatitis C screening in community pharmacy.

OBJECTIVES: To determine patients' awareness of the screening recommendations for hepatitis C virus (HCV) in "Baby Boomers," to assess patients' willingness to receive a point-of-care HCV screening test in the pharmacy, and to determine patients' barriers to receiving a point-of-care HCV screening test in a community pharmacy. METHODS: An anonymous 12-question survey was developed. Five shareholder pharmacies of American Pharmacy Services Corporation (APSC) volunteered to participate. Surveys were mailed to participating pharmacies with instructions to distribute to patients born in 1945 to 1965 at the pharmacy point-of-sale. Data were collected over a 12-week period from October 2016 to January 2017. Completed surveys were collected by participating pharmacies and mailed to the primary investigator. Data were analyzed with the use of descriptive statistics. RESULTS: Ninety-five eligible surveys were returned and analyzed. A majority of respondents were female (63.00%) and held a bachelor degree or higher (63.16%); 38.95% of patients were aware of HCV age-based risk factors and screening recommendations. Only 9.80% of patients were aware of the fingerstick point-of-care testing (POCT) option for HCV. Nearly three-fourths (71.70%) were willing to receive POCT at a community pharmacy. A majority of patients (65.52%) were unwilling to pay an amount that would cover the cost of testing. Descriptive statistics, including a Pearson chi-square test, were used to analyze the data. Significant differences in the distribution of the percentages of people willing to receive testing and to pay for testing were found among levels of annual household income. CONCLUSION: A majority of patients are willing to receive POCT at a community pharmacy. Patients were unwilling to pay for testing, however, so pharmacies looking to offer point-of-care HCV screening would need to secure further financial resources, such as insurance reimbursement or grant funding, for this service to be financially feasible.

Implementation of personalized medicine services in community pharmacies: perceptions of independent community pharmacists.

OBJECTIVES: To evaluate the perceptions of independent community pharmacists within a regional independent community pharmacy cooperative on implementing personalized medicine services at their pharmacies and to gauge the pharmacists' self-reported knowledge of pharmacogenomic principles. DESIGN: Descriptive, exploratory, nonexperimental study. SETTING: American Pharmacy Services Corporation (APSC), 2011-12. PARTICIPANTS: Pharmacists (n = 101) affiliated with the independent pharmacies of APSC. INTERVENTION: Single-mode survey. MAIN OUTCOME MEASURES: Independent community pharmacists' interest in implementing personalized medicine services, perceived readiness to provide such services, and perceived barriers to implementation. RESULTS: 101 completed surveys were returned for data analysis. The majority of pharmacists surveyed (75%) expressed interest in offering personalized medicine services. When asked to describe their knowledge of pharmacogenomics and readiness to implement such services, more than 50% said they were not knowledgeable on the subject and would not currently be comfortable making drug therapy recommendations to physicians or confident counseling patients based on results of genetic screenings without further training and education. Respondents identified cost of providing the service, reimbursement issues, current knowledge of pharmacogenomics, and time to devote to the program as the greatest barriers to implementing personalized medicine services. CONCLUSION: The majority of independent community pharmacists are interested in incorporating personalized medicine services into their practices, but they require further education before this is possible. Future initiatives should focus on the development of comprehensive education programs to further train pharmacists for provision of these services.

Independent community pharmacist interest in participating in community pharmacy research networks.

OBJECTIVES: To assess the interest of American Pharmacy Services Corporation (APSC) independent community pharmacists in participating in a community pharmacy research network (CPRN) and to identify perceived barriers to participation in a CPRN. DESIGN: Descriptive, exploratory, nonexperimental study. SETTING: University of Kentucky and APSC during 2009-10. PARTICIPANTS: 65 APSC independent community pharmacists in Kentucky. INTERVENTION: Single-mode survey. MAIN OUTCOME MEASURE: Independent community pharmacists' willingness to participate in community-based research and perceived barriers to participation. RESULTS: A total of 65 independent community pharmacists from 191 pharmacies returned the survey. The majority of independent community pharmacists were "interested" or "very interested" (83.8%) in participating in a CPRN. Respondents were willing to participate for a mean (±SD) of 6.5 ± 5.8 hours per week. However, they reported only being able participate in a CPRN for 5.2 ± 4.1 hours per week, with time being the greatest limitation to participation. An overwhelming percentage of respondents (92.1%) were interested in learning more about opportunities to participate in a CPRN in the future. CONCLUSION: CPRNs are an emerging interest in community pharmacy practice. A CPRN is an opportunity for independent community pharmacies to collaborate and use resources as a group to conduct research to solve issues in the community pharmacy setting.