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Doorway to a New Era Pharmacists as Public Health Partners. Diana Fortune RN, BSN TB Program Manager New Mexico TB ETN/PEN 2012. November 2010. NM Pharmacist Association contacted TB program – Considering prescriptive authority for pharmacists to place TSTs Regulatory agencies - PowerPoint PPT Presentation
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Diana Fortune RN, BSNTB Program Manager
New Mexico
TB ETN/PEN 2012
Doorway to a New EraPharmacists as Public Health Partners
NM Pharmacist Association contacted TB program – Considering prescriptive authority for pharmacists to place TSTs◦ Regulatory agencies
Medical Board Nursing Board Department of Health
TB Program
NM pharmacists large range of prescriptive authority◦ Lack of accessible health care in many areas
November 2010
Background on New Mexico
Land of Enchantment: Fun Facts Do NOT need passport
State Question?◦ Red or Green
Breaking Bad◦ Filmed here!
5th largest state – land mass◦ 121,000 sq miles
6th LEAST populated◦ 2 million
1912 – bilingual gov’t◦ No official language
Decrease public health $$
Lack of nursing staff
Remote areas of State
Barriers to accessible TSTs
Newspaper Coverage……
Prescriptive Authority◦March 7, 2011 – protocol was added for Pharmacist to
administer TSTs (regulation16.19.26.12) Initially indicated the pharmacists view
CDC “Mantoux Tuberculin Skin Test Video for their training…
NM Board of Pharmacy
Met on June 2, 2011◦ TB Program (TBP)◦ Pharmacist Association◦ Board of Pharmacy
NM TBP leading roll in education of pharmacists TST training◦ Press release on August 31, 2011◦Webinar – Heartland National TB Center; Sept 8, 2011
Understanding the TST: A Primer for Non-TB Staff (Diana Fortune) Open to other states – 61 registered attendees Required for NM Pharmacists to view prior to TST Practicum
Archived @ Heartland & NM Pharmacists Association website
Official collaboration begins…..
Division of Services……
Pharmacists Testing Public Health Testing
Low-Risk Population (TSTs)◦ Pharmacists to test
School Work Change of immigration status
High-Risk Populations◦ Tested @ public health dept.
TB suspects Contacts Immune compromised
HIV TNF-alpha blockers Other immune compromised
In addition…… TST Health History◦Utilize DOH standardized form◦Accurate reading of TST
CDC cut-points Referral of +TST◦ CXR prior to health dept referral◦May refer to PCP
Refer high-risk clients to public health◦Do not test at pharmacy
CEU provided by NM Pharmacist Association
September 25, 2011
Five TST practicums held since September
Total of 50 pharmacists attended
Several hundred TSTs performed: < 5 positive TSTs
TST Practicums…..
Informal by NM Pharmacist Association◦ Participating pharmacists indicated a confidence in their
ability to provide this service to the public
◦Around 100 TST applied no positive TSTs (at time of survey)
Project Evaluation
“Outcomes of a Pharmacist Performed Tuberculosis Testing Initiative in New Mexico”◦ University of New Mexico College of Pharmacy
Objectives◦ Provide a qualitative assessment of the TSTs performed by pharmacists
& identify potential benefits of providing TST at community pharmacies◦ Evaluate outcomes of TB testing performed in a community pharmacy
setting◦ Describe the standardized training for pharmacists to accurately place,
read and interpret the TST.
Formal Project Evaluation
• Increased access to TSTs
• Pharmacists referrals when clients presented with signs or symptoms of TB disease
• In the era of declining public health dollars • all avenues of collaboration to ensure sustained TB
prevention efforts should be explored
In conclusion: