Tuberculin skin testing by pharmacists in a grocery store setting

Objective: To report experiences of pharmacist-provided tuberculin skin testing in 18 patients. Setting: A grocery store pharmacy in Yakima, Wash., from February 2006 to December 2006. Practice description: Pharmacists in this location provide a variety of clinical services in addition to their dispensing duties, including rapid streptococcal testing and eradication, travel vaccines and malaria prophylaxis, Helicobacter pylori testing and eradication, cholesterol screening, diabetes screening, and meter education. Practice innovation: Fred Meyer pharmacists had the opportunity to take a 9-hour continuing education course and training, become certified as an immunizer, complete a hepatitis B vaccination series, have current cardiopulmonary resuscitation training, and demonstrate proper intradermal administration of purified protein derivative (PPD). Pharmacists licensed in Washington state can determine the need for and administer PPD under a protocol agreement with an authorizing prescriber.. As health care's most accessible practitioner, the pharmacist has a unique opportunity to advocate public health initiatives. Using this protocol, pharmacists use their unique access to patients and their knowledge and skill to administer and read the tuberculin tests. Results:Two pharmacists completed the training, and 18 tuberculin skin tests were administered and read from February to December 2006. Tests were quickly administered, requiring less than 10 minutes per patient, and all but one patient returned within the required 48-72 hours for reading of the test. Because third-party billing was not available at the time, patients paid out of pocket for the tests. Patients needed the tests for a variety of reasons, including new jobs that required tests, patients beginning drug treatment programs, and couples seeking to adopt children. Conclusion: Tuberculin skin testing is easily incorporated into workflow in community pharmacy, provides a valuable community service, and fulfills our goal of providing accessible, inexpensive health care services to the Yakima community.