The Critical Role for Community Pharmacies during a Public Health Emergency

The Critical Role for Community Pharmacies during a Public Health Emergency

May 20, 2019

May 20, 2019 - Pharmacies are a vital part of communities and healthcare ecosystems and can serve as important participants in a public health emergency response.  The role of the pharmacists has expanded to include the provision of prevention activities such as immunizations, laboratory testing, chronic disease screening and medication management, and providing primary care services, where allowable by state laws and regulations. In fact, almost a third of adults who received influenza immunizations in 2018, were vaccinated at community pharmacies.[1]  Public health can leverage these capabilities and the convenience and accessibility of pharmacies to serve the community during an influenza pandemic or other emergency.

Pharmacies serve communities in multiple ways during an emergency response by:

  • Ensuring patients have access to their ongoing medications and uninterrupted access to services;
  • Detecting patterns and trends in the uptake of over-the-counter medications as part of surveillance before, during, and after an outbreak or emergency;
  • Dispensing medical countermeasures for treatment or prophylaxis;
  • Administering and tracking vaccines;
  • Providing accurate and timely information and education to patients, especially to medically underserved populations;
  • Providing direct consultation, assessment and treatment, where appropriate and allowable by state laws and regulations; and
  • Ensuring continuity of function as a critical community healthcare destination.

Pharmacies can extend the reach of public health and make considerable contributions during a public health emergency response, especially when they are engaged in planning and preparedness in advance of an emergency. Mutually beneficial partnerships between public health and pharmacies are being developed, yet barriers still exist. Currently, community pharmacies are under-recognized and under-utilized as providers of adult immunizations and other preventive services, and may not receive adequate reimbursement for the services provided.[2] Improvement of state laws and regulations to expand services that pharmacists can offer every day while also addressing current coverage and reimbursement limitations for patient care services can augment the value pharmacies can provide in their communities, and boost the ability of pharmacies to provide critical services during a pandemic or other emergency response.

Recommendations (for more information)

  • Engage pharmacies in planning as part of ongoing community emergency response planning, well ahead of an outbreak. Consider how pharmacies can provide vaccination and other services during a pandemic. Establishing trusted partnerships in advance of an emergency can provide a platform for rapid response.[3]
  • Consider how pharmacies can partner with public health to improve the provision of everyday preventive care services. Emergency response efforts can be improved by building on familiar and existing everyday processes, rather than developing new processes to be used only for emergencies.
  • Involve pharmacies in routine provision of targeted health education and health promotion as part of public health campaigns. Patient visits to pharmacies are almost nine times greater than primary care visits per year.[4] Therefore, pharmacies have a greater opportunity to deliver preventive health messages and services as trusted healthcare providers.
  • Review local and state laws and regulations to assess opportunities to reduce barriers that may hinder pharmacy engagement, such as age restrictions on providing immunizations and state/local regulations that govern how patient care services can be provided by pharmacists under a public health emergency. Consider how Gubernatorial Executive Orders or other strategies could be used during an emergency to reduce these barriers.[5]
  • Explore how community pharmacies can participate in emergency medical countermeasure and vaccination programs. In the 2009 H1N1 pandemic, distribution of vaccine to pharmacies was delayed until December 2009, after the disease had peaked and public demand for vaccination had waned. By incorporating pharmacies in public health pandemic vaccination plans and by providing vaccines to pharmacies early in a response, more can be vaccinated during a pandemic. Pharmacists are willing to serve the public during a pandemic, but they need to be incorporated into planning in advance.[6]

Including pharmacies in state and local pandemic planning and response can increase the effectiveness of a public health emergency response; outreach and planning efforts are needed now. Further, providing pharmacists with broader authority to conduct patient care services every day can have added benefit in times of disaster too.

 

 

[1] Centers for Disease Control and Prevention. Early-Season Flu Vaccination Coverage–United States, November 2018  https://www.cdc.gov/flu/fluvaxview/nifs-estimates-nov2018.htm.

[2] Fitzgerald TJ, Kang Y, Bridges CB, Talbert T, Vagi SJ, Lamont B, and Graitcer SB. Integrating pharmacies into public health program planning for pandemic influenza vaccine response. Vaccine. 2016 November 04; 34(46): 5643–5648.

[3] Rubin SESchulman RMRoszak ARHerrmann JPatel AKoonin LM. Leveraging partnerships among community pharmacists, pharmacies, and health departments to improve pandemic influenza response. Biosecur Bioterror. 2014 Mar-Apr;12(2):76-84.

[4] Moose J and Branham A. Pharmacists as Influencers of Patient Adherence. Pharmacy Times. August 21, 2014.

[5] Sunshine GThompson KMenon ANAnderson NPenn MKoonin LM. An Assessment of State Laws Providing Gubernatorial Authority to Remove Legal Barriers to Emergency Response. Health Security. 2019 Apr 3. [Epub ahead of print]

[6] SteelFisher GKBenson JMCaporello HKoonin LMPatel ABen-Porath EBlendon RJ. Pharmacist Views on Alternative Methods for Antiviral Distribution and Dispensing During an Influenza Pandemic. Health Security. 2018 Mar/Apr;16(2):108-118.

 

Sara E. Roszak, DrPH

Sara E. Roszak, DrPH, Vice President, Pharmacy Care & Health Strategy, & Vice President, NACDS Foundation joined the National Association of Chain Drug Stores (NACDS) in November, 2014 and has assisted in developing innovative research initiatives and executing projects and grants. Roszak was awarded with the prestigious Jay S. Drotman Memorial Award for young professionals for her contributions to the advancement of public health initiatives. Roszak received a Bachelor of Science degree in Journalism and a Bachelor of Arts degree in political science from the University of Florida, a dual masters degree in international affairs and public health from the George Washington University, and holds a Doctoral of Public Health in Health Leadership degree from the University of North Carolina at Chapel Hill.