Pharmacists performing hepatitis C antibody point-of-care screening in a community pharmacy: A pilot project

Dong, Betty J.; López, María Isabel; Cocohoba, Jennifer

doi:10.1016/j.japh.2017.04.463

Cited by 36 publications

(55 citation statements)

References 8 publications

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“…In addition to accessibility, patients consistently rank pharmacists as one of the most trusted health care providers. With the expansion of the role of the community pharmacist to include administering vaccinations, conducting medication therapy management, and POC testing for diabetes and cardiovascular diseases, pharmacists have established an environment that allows for POC testing for infectious diseases (Gubbins et al, 2014) Factors that may present as challenges or barriers to pharmacists conducting POC testing at their community pharmacy sites include comfort in discussing unfavorable test results to patients, workflow integration of POC testing, and lack of exposure and knowledge of HIV and/or HCV (Dong, Lopez, & Cocohoba, 2017;Kehrer & James, 2016;Ryder, Meyerson, Coy, & von Hippel, 2013;Weidle et al, 2014).…”

Section: > > Backgroundmentioning

confidence: 99%

Pharmacist Comfort and Awareness of HIV and HCV Point-of-Care Testing in Community Settings

Min

Andres

Grover

et al. 2019

Health Promotion Practice

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Objective. To address the public health concern of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) transmission, various intrapersonal and organizational factors were identified to explore opportunities for pharmacists as part of a HIV/HCV prevention strategy. The awareness and comfort of pharmacists practicing in independent pharmacies and student pharmacists on providing HIV and HCV point-of-care (POC) tests in an urban setting were investigated. Method. Surveys were anonymously completed by pharmacists practicing in independent pharmacies within a 2-mile radius of our institution and student pharmacists attending our institution. Surveys were administered over a period of 10 weeks. Data were analyzed using descriptive statistics. Results. A total of 119 pharmacy students and 23 practicing licensed pharmacists completed the survey. Only 21.7% of pharmacists were aware that HIV and HCV screenings are available as POC tests. Pharmacists were more likely to feel comfortable administering other POC tests and not HIV or HCV POC tests. Student pharmacists felt more comfortable than pharmacists in administering HIV and HCV POC tests and had a higher perceived level of comfort of their ability to administer these tests as licensed pharmacists. Conclusions. In this urban setting, awareness and comfort in pharmacist-provided HIV and HCV POC testing is low, however, with proper training and education, pharmacists in these community pharmacy practice settings can expand HIV and HCV screening opportunities for the community.

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Section: > > Backgroundmentioning

confidence: 99%

Pharmacist Comfort and Awareness of HIV and HCV Point-of-Care Testing in Community Settings

Min

Andres

Grover

et al. 2019

Health Promotion Practice

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“…Rapid POC testing has been used widely for many years to overcome obstacles in infectious disease screening. 12 Additionally, many studies have demonstrated that using peer/community members 13 for HCV POC testing, or testing in which people receive other services [14][15][16] improves the diagnostic cascade of care for HCV. However, further improvements are possible: shortening the 20-minute read time of the OQ test could significantly increase its utility in both high-and lowincome settings.…”

Section: Discussionmentioning

confidence: 99%

Reducing Read Time of Point-of-Care Test Does Not Affect Detection of Hepatitis C Virus and Reduces Need for Reflex RNA

Smookler

Vanderhoff

Biondi

et al. 2021

Clinical Gastroenterology and Hepatology

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BACKGROUND & AIMS: Global elimination of hepatitis C virus (HCV) will require increases in diagnosis. Point of care (POC) tests that detect antibodies against HCV can be useful for testing large and difficult to reach populations. The most accurate POC test requires a 20 min read time to identify antibodypositive samples. We investigated whether viremic patients could be identified using a shorter read time, to increase efficiency and reduce the need for reflex tests (a follow-up test for HCV RNA on the same specimen, to confirm viremia). METHODS: Patients with past or current HCV infections provided samples at 2 clinics in Canada for evaluation by the OraQuick HCV Rapid antibody POC test. A community HCV-screening program in Madrid, Spain (real-world cohort) invited people to be tested for HCV with the same OraQuick test. Patients provided samples of whole blood, via finger prick. Fingerprick samples were tested immediately after collection. In the clinical cohort, photographs of the developing test were taken at 15 second intervals, and blinded readers recorded the time to positivity. In the real-world cohort, readers recorded the OraQuick result each minute, from 5-10 minutes and then again at 20 minutes; viremia was then evaluated using a POC HCV RNA test (GeneXpert HCV Viral Load Assay). Sera from viremic and non-viremic clinic patients were used to quantify antibody titers to investigate the relationship between the time of band appearance and antibody concentration. Fisher's exact test and exact logistic regression were used to determine factors associated with a positive result at 5 minutes. RESULTS: Blood from all viremic patients produced a positive result in the antibody POC test by 5 min. Median time to a positive result for 171 viremic patients was 2.6 min (range, 1.8-4.6 min), vs 4.1 min (range, 2.3-14.4 min) for 108 patients with resolved infection (P < .001). The 5-min threshold identified all viremic cases among 176 HCV antibody-positive patients in the realworld cohort, confirmed by the test for HCV RNA. In the pooled cohorts, antibody positivity at 5 min identified viremic patients with 100% sensitivity (95% CI, 98.4%-100%); the negative predictive value was 100% (95% CI, 94.9%-100%). The positive predictive value at 5 min was 62.0% (95% CI, 56.7%-67.0%) and therefore insufficient alone to detect viremia; an HCV RNA test would still be necessary to confirm active infection.

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“…Other services include immunizations, pharmacist-initiated naloxone (per statewide protocol), over-the-counter syringe distribution and disposal of used syringes, free sharps container distribution and substance use treatment referrals, and pointof-care HIV and HCV testing. 6 Adherence services include monitoring of pharmacy refill data, patient assessment of adherence, bubble pack packaging, reminder calls, and delivery services. The PrEP demonstration project is one of several new programs implemented over the past 5 years to expand and improve patient care.…”

Section: Practice Descriptionmentioning

confidence: 99%

Implementation of pre-exposure prophylaxis at a community pharmacy through a collaborative practice agreement with San Francisco Department of Public Health

López¹,

Cocohoba²,

Cohen³

et al. 2020

Journal of the American Pharmacists Association

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Pharmacists performing hepatitis C antibody point-of-care screening in a community pharmacy: A pilot project

Cited by 36 publications

References 8 publications

Pharmacist Comfort and Awareness of HIV and HCV Point-of-Care Testing in Community Settings

Pharmacist Comfort and Awareness of HIV and HCV Point-of-Care Testing in Community Settings

Reducing Read Time of Point-of-Care Test Does Not Affect Detection of Hepatitis C Virus and Reduces Need for Reflex RNA

Implementation of pre-exposure prophylaxis at a community pharmacy through a collaborative practice agreement with San Francisco Department of Public Health

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