California Community Pharmacist Preparedness in Ordering and Interpreting Laboratory Tests

Angelica Del Rosario, Kathleen Feng, L. Haddad, Brian Lee, Ryan Murakami, Eric Pinashin, Ashley Tuttle, Kevin R. Young, M. Durham, E. Mirzaian
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Abstract

Introduction The passage of Senate Bill 493 (SB 493) granted California pharmacists the ability to order and interpret lab tests without physician approval. Despite this legislation, not all pharmacists are aware of, or exercise, this authority. The goals of this study are to describe 1) pharmacists' willingness, 2) perceived factors influencing pharmacist preparedness, and 3) challenges and barriers to ordering laboratory tests in the community setting. Methods This is a prospective, descriptive survey study that was performed using online survey software from August 31, 2017, to October 4, 2017. An anonymous link was distributed to California pharmacists via California Society of Health-System Pharmacists (CSHP) and California Pharmacists Association (CPhA) email newsletters. Additionally, targeted interviews of pharmacists were conducted by phone to qualitatively assess barriers as well as successful practices. Institutional Review Board (IRB) approval was obtained prior to initiating the study. Results Sixty-six pharmacist respondents completed the online survey. The reported two biggest barriers to ordering lab tests identified by community pharmacists were 1) lack of available time and 2) compensation structure. Despite these barriers, most pharmacists were willing to order and interpret laboratory tests and accept the liability, regardless of a reimbursement guarantee. Conclusions Community pharmacists self-report preparedness to order and interpret laboratory tests. Barriers in carrying out this task include lack of staff, resources, compensation, and reimbursement structure.
加州社区药剂师准备订购和解释实验室测试
参议院493号法案(SB 493)的通过赋予加州药剂师无需医生批准即可订购和解释实验室测试的能力。尽管有这项立法,但并不是所有的药剂师都知道或行使这项权力。本研究的目的是描述1)药剂师的意愿,2)影响药剂师准备的感知因素,以及3)在社区环境中订购实验室检测的挑战和障碍。方法这是一项前瞻性描述性调查研究,于2017年8月31日至2017年10月4日使用在线调查软件进行。通过加州卫生系统药剂师协会(CSHP)和加州药剂师协会(CPhA)电子邮件通讯向加州药剂师分发了一个匿名链接。此外,通过电话对药剂师进行有针对性的访谈,以定性评估障碍以及成功的做法。在开始研究之前获得了机构审查委员会(IRB)的批准。结果66名受访药师完成了在线调查。据报告,社区药剂师指出,订购实验室检测的两个最大障碍是:1)缺乏可用时间;2)补偿结构。尽管存在这些障碍,大多数药剂师愿意订购和解释实验室测试并接受责任,而不管是否有报销保证。结论社区药师自述准备订购和解释实验室检查。执行这项任务的障碍包括缺乏人员、资源、薪酬和偿还结构。
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