Evaluation of a pharmacist-performed tuberculosis testing initiative in New Mexico

Objective: To report experiences of the New Mexico pharmacist tuberculosis (TB) testing program. Setting: Community pharmacies in New Mexico interested in participating in the TB testing initiative from March 2011 to August 2013. Practice innovation: To expand accessibility of TB testing, New Mexico pharmacists were granted the authority to prescribe, administer, and read tuberculin skin tests (TSTs) in March 2011. To receive this special prescriptive authority, pharmacists had to complete a New Mexico Department of Health training program in accordance with the Centers for Disease Control and Prevention guidelines. Evaluation: Data were collected on the number of TSTs performed and the TST reading follow-up rate. Patient data collected were demographic information, reason for obtaining a TST (e.g., immigration, school, or work), TB risk factors, and TST results. Results: In New Mexico, 43 pharmacists were certified for TB testing during the evaluation period, 25 of whom were actively prescribing and performing TB testing at eight community pharmacies. There were 606 tests administered to 578 patients; 70.9% women, median age 31 years (4-93 years). Employment and school were the main reasons for obtaining a TB test. A total of 578 of 623 (92.8%) patients followed up to have their TSTs read. A total of 18 positive tests (3.1% positivity rate) were identified and appropriate referrals were made. Conclusion: New Mexico expanded the scope of practice for pharmacists. Pharmacist-performed TB testing had a valuable public health benefit. TB testing follow-up rates at community pharmacies in New Mexico were high, most likely due to convenient hours, accessible locations, and no required appointments.