ASPO Abstracts
Testing colorectal cancer screening distribution in two community pharmacies in North Carolina: Findings from the PharmFIT Study
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: To develop and test a model for distributing fecal immunochemical tests (FIT) for colorectal cancer (CRC) screening in community pharmacies. Methods: Working with two community pharmacies and two primary care clinics in North Carolina, we developed protocols for a pharmacy-based CRC screening program (PharmFIT). We conducted collaborative process mapping exercises during project meetings with pharmacists and primary care providers (PCPs) to tailor the program to each pharmacy/primary care context. Two PharmFIT models emerged (Model A and Model B). In Model A, one PCP identified eligible patients and sent e-scripts for patients to pick up FITs at the pharmacy. In Model B, a self-insured employer group notified beneficiaries of FIT availability at the pharmacy. Those interested called the pharmacy and eligibility was determined; those eligible picked up FITs at the pharmacy. In both Models, patients mailed completed FITs to labs for processing. Pharmacists and staff managed reminder calls, tracking (including FIT return), counseling, results reporting, and collected patient demographics. Implementation evaluation surveys were administered to patients, pharmacists, and PCPs. Results: Patients from Model A were 83% black, 50% had at least some college education, and 56% had Medicaid or Medicare. Twenty-nine e-scripts for eligible patients were sent to the pharmacy, 24 patients picked up the FIT, and 21 completed and returned the FIT (72% response; 88% return). Patients from Model B were 93% white, 100% some college or more, and 93% privately insured. Twenty-five patients contacted the pharmacy of whom 15 were eligible for FIT. Fourteen picked up a FIT, all of whom completed and returned the FIT (93% response; 100% return). In both Models, all FIT results were negative. Pharmacists and PCPs shared considerations for future implementation and scale-up. Survey results from patients (n=30), pharmacy staff (n=3), and PCPs (n=2) indicated high acceptability and satisfaction with PharmFIT. Conclusion: Tailoring and implementing context-specific protocols for the PharmFIT program resulted in high FIT completion rates, acceptability, and satisfaction among participants, suggesting that it is feasible to expand CRC screening to the community pharmacy setting.
Keywords: colorectal cancer screening, pharmacy, early detection, enhanced community pharmacy services