Patient preferences for the design of a pharmacy-based colorectal cancer screening program

Abstract

Purpose To assess preferences for design of a pharmacy-based colorectal cancer (CRC) screening program (PharmFIT™) among screening-eligible adults in the United States (US) and explore the impact of rurality on pharmacy use patterns (e.g., pharmacy type, prescription pick-up preference, service quality rating). Methods We conducted a national online survey of non-institutionalized US adults through panels managed by Qualtrics, a survey research company. A total of 1,045 adults (response rate 62%) completed the survey between March and April 2021. Sampling quotas matched respondents to the 2010 US Census and oversampled rural residents. We assessed pharmacy use patterns by rurality and design preferences for learning about PharmFIT™; receiving a FIT kit from a pharmacy; and completing and returning the FIT kit. Results Pharmacy use patterns varied, with some notable differences across rurality. Rural respondents used local, independently owned pharmacies more than non-rural respondents (20.4%, 6.3%, p < 0.001) and rated pharmacy service quality higher than non-rural respondents. Non-rural respondents preferred digital communication to learn about PharmFIT™ (36% vs 47%; p < 0.001) as well as digital FIT counseling (41% vs 49%; p = 0.02) more frequently than rural participants. Preferences for receiving and returning FITs were associated with pharmacy use patterns: respondents who pick up prescriptions in-person preferred to get their FIT (OR 7.7; 5.3–11.2) and return it in-person at the pharmacy (OR 1.7; 1.1–2.4). Conclusion Pharmacies are highly accessible and could be useful for expanding access to CRC screening services. Local context and pharmacy use patterns should be considered in the design and implementation of PharmFIT™.

The Critical Role of Pharmacists in the Clinical Delivery of Pharmacogenetics in the U.S

“…More recently, following the pandemic and pharmacists' expanded authority regarding testing services [106], it is possible that this experience will advance a greater role for pharmacists with respect to clinical testing in general, and more specifically for PGx testing. However, while the continued expansion of pharmacy services to include testing may yield economic benefits for pharmacies and increase access to various services for patients [107,108], an expanded role beyond the traditional roles of dispensation and patient counseling (via community-based pharmacists) [109] may not be wholly supported by physicians, and factors such as pharmacists' clinical expertise and control influence physicians' attitudes [110,111]. However, in the community setting (or a centralized service serving multiple sites), pharmacists are not likely to have access to a patient's full medical record or medication history, thereby limiting their ability to interpret the clinical significance of the PGx test results [43].…”