Implementing Point-of-Care Testing and Pharmacogenetic Testing in the Community Pharmacy

Kaitlyn Waters:
Hello, everyone, and welcome to this podcast from Cambridge Healthtech Institute for the Next Generation Diagnostic Summit, which runs August 15 - 18, 2017 in Washington, DC. I'm Kaitlyn Waters, Associate Conference Producer. We have with us, today, one of our speakers from the Pharmacy-Based Point-of-Care Testing Conference, Dr. Edana Holliday, Clinical Pharmacist at Rx Clinical Pharmacy and Vice-President of Communications at the Pharmacogenetics Center of Excellence. Dr. Holliday, thank you for joining us today.

Edana Holliday:
Thank you for having me, Kaitlyn.

Kaitlyn Waters:
Pharmacogenetic testing is a fairly new technique to determine patient medications and doses. Can you explain how Rx Clinical Pharmacy is using pharmacogenetic testing?

Edana Holliday:
Yes, Rx Clinic Pharmacy in Charlotte, North Carolina ... We're a small, independent pharmacy. We're really moving the way we provide care to our patients in more of a patient-centered direction, and more geared toward precision medicine and making sure that our patients know that we are a very valuable part of their healthcare team. We have a couple different areas where we do use this. We do use this in our retail setting, but we also use this in our ambulatory care branches, where we have pharmacists are actually going into clinics and working with providers on a daily basis as well.

We actually will test the patients at the store or in the clinic. Then, when they receive their results back, we will go over the results, sit down, provide any preventative care, counseling methods that we need to go over the current medications that they're on, and any future medications they may be on, that may not agree with their genetic results or implications.

Kaitlyn Waters:
What are some of the ways that you are seeing medical doctors and pharmacists collaborate to improve the patient care?

Edana Holliday:
What we've seen is a wonderful collaboration, and a wonderful -just- teamwork between our providers and our pharmacists; especially in our ambulatory care section and sector, where our providers are able to depend on our pharmacists. The pharmacists or the provider may recommend that a patient go do the testing. Through that process, the medical provider and the pharmacist are able to work together, once the results are in, to decide what's the best regimen for that patient.

The way the program that we use works is that the patient is not able to see the results until they have a one-on-one consultation with the pharmacist. After that, those results are passed on to the medical provider. Between the two of them, they come to terms with a regimen that works for the patient. This has, especially, been wonderful for our patients that suffer from depression, from anxiety; especially our patients that are having a lot of issues and have been diagnosed with acute coronary syndrome, or need to be on blood thinners or anti-platelet therapies. Those are the patients that we've seen the most impact with, but this has definitely been a wonderful opportunity for providers and pharmacists to come together to develop regimens for patients.

Kaitlyn Waters:
What do you think are some of the barriers to making pharmacogenetic testing standard of care?

Edana Holliday:
We actually did a small research project with our pharmacists. One of our pharmacists was able to actually do a survey, in the state of North Carolina, with a lot of our pharmacists to see what the barriers were. Based on that research, we were able to determine one barrier is definitely cost. I'm not exactly saying that it's the cheapest method right now, but a lot of times providers and pharmacists believe it's too expensive for their patient; so they don't even offer, because they automatically believe the patient can't afford it. That's definitely a barrier.

Another barrier is just the education, making sure that there is someone who understands the genetic component as well as the genetic implications regarding and surrounding these medications. That they can sit down and actually bring the medication and break the information down into a way and a method that the patient can understand and take that information home and able to work with their providers and their pharmacists to develop a regimen that works for them. I believe those are the two main barriers; again cost, and then definitely making sure that the knowledge is there and that foundation is set.

Kaitlyn Waters:
Finally, in what ways is the Rx Clinical Pharmacy expanding it's point-of-care testing?

Edana Holliday:
As I alluded to before, we have really branched out in terms of working with other pharmacists and helping them get trained. That's one aspect. We work with pharmacists around the country and help them get trained in order to explain genetic information to patients. Another thing we do is we have taken it into our ambulatory care sector, and working with our clinical pharmacists and our providers, there all of our pharmacists offer pharmacogenetic testing and that point-of-care testing as well. Then, we brought it into our other stores. If we do have a satellite location that's located inside of the clinic, and we brought it there as well. It's a wonderful blend of those retail community pharmacies as well as ambulatory care pharmacies. We're taking this technology to the world.

We're also working on courses and programs for students who are interested, pharmacy students who are interested in just learning more about this and learning how to talk and speak to patients, and help them understand this information; as well as how to talk to providers, and explain what this is and how it can help us in the future. We've gone and taken a big approach in terms of advocacy and education to make sure that everyone understands precision medicine; it's here to stay. In order for us to take the best possible care of our patients, we do have to move toward a more patient-centered, patient-direct care.

Kaitlyn Waters:
Thank you for your time and your insights today, Dr. Holliday.

Edana Holliday:
Thank you so much. I really enjoyed speaking with you today.

Kaitlyn Waters:
That was Dr. Edana Holliday from the Pharmacogenetic Center of Excellence and Rx Clinical Pharmacy. She will be speaking at the Pharmacy-Based Point-of-Care Testing Conference, which is a part of the upcoming Next Generation Diagnostic Summit, running August 15 - 18, 2017. I'm Kaitlyn Waters; thank you for listening.