Pharmacists play role in Wash. pertussis epidemic
Recently, a disease that was long a deadly scourge in the United States has resurfaced: whooping cough.
In April, public health authorities in Washington state declared an epidemic of the childhood disease, also known as pertussis, following a nearly tenfold increase in the number of cases. In May, the state Department of Health found 1,248 cases of the illness, compared with almost 130 at the same time last year. The staggering rise, producing numbers not seen since the 1940s, prompted Gov. Chris Gregoire to announce that emergency funding would be made available to the health department to try and curb the epidemic. The disease is particularly dangerous for infants, and about half of those younger than 1 year old require hospitalization. In light of the situation in Washington, the Centers for Disease Control and Prevention approved the use of federal money designated for other immunizations to buy more than 27,000 doses of pertussis vaccine for adults who are uninsured or underinsured.
There are many reasons for the epidemic, Washington state Department of Health communications director Tim Church told Drug Store News, but in many cases, kids are getting it from adults, who may not be aware that while childhood vaccinations against pertussis may protect against the disease for a while, they can also wear off over time. “That’s why we’re so intent on getting the word out that adults need to get vaccinated,” Church said. “There are far too few adults vaccinated against pertussis.”
Another reason is that the disease is cyclical, Church said; some years have few cases, and some have many. But in this instance, there are even more cases in Washington than there normally would be in a bad year.
Currently, Washington’s state health department offers vaccinations for children for free, and the CDC recommends that children get the Tdap vaccine at age 11. But adults, Church said, are largely on their own. Because Washington has one of the highest rates of parents opting out of getting their kids vaccinated before starting kindergarten, it was suggested in some media reports that it could be one of the reasons for the epidemic, though that remains uncertain.
With the state having limited resources to fight the epidemic, pharmacy retailers have an opportunity to step in where the state doesn’t. In the wake of the state’s declaration of an epidemic, Rite Aid and Walgreens announced the shipment of extra doses of the Tdap vaccine to their stores. Church said he had never seen retail pharmacies so actively promoting Tdap vaccines for adults. “We’ve been pleased with what’s been happening with pharmacies in Washington state,” Church said. “They’re promoting the whooping cough vaccine like never before.”
Pharmacy retailers, Church said, were in a good position to promote the vaccine. “Pharmacists are among the most trusted health providers out there, so we sure would love to see pharmacists ask people coming through if they’re aware there’s a whooping cough outbreak,” Church said. “If people hear those things from pharmacists, it’ll help get more people vaccinated. Retail pharmacies have a lot of resources we don’t have.”
Our surprising readership
Sometimes even I am surprised by who is reading us. Last month, nearly 120,000 unique visitors came to DrugStoreNews.com. One of them was president of the American Academy of Family Physicians Glen Stream.
“In her May 23 article, ‘Physician-authored JAMA article highlights importance of retail clinics, drug store medicine,’ Antoinette Alexander highlights a recently published article that shares a vision for retail health clinics that completely outstrips the capability of these clinics as they are currently configured,” Dr. Stream wrote in his May 31 letter to the editor. To read the entire letter, visit click here.
It does seem odd, though, that the president of a big, national physician’s organization is writing the editor of DSN to debate an article that actually appeared in the Journal of the American Medical Association. But why split hairs? Let’s just chalk it up to DSN’s extensive reach.
Christine Cassel of the American Board of Internal Medicine, the actual author of the JAMA article, half-predicted Stream’s response — and others like him — in her conclusion:
“The question is whether this phenomenon will grow and flourish in the ways described here or whether 20th century attitudes about physician and hospital dominance in health care will prevent market-based solutions to the healthcare access and cost crisis. This model is a challenge to medical and hospital leadership, as well as to leaders in the retail health clinic industry, as they pursue the potential opportunities and benefits for the American people.”
I may not be smart enough to be the president of the American Academy of Family Physicians. But I’m smart enough to know how to read, and Dr. Cassel, at no point in her article, suggested that retail clinics could or should replace the role of the physician. “The retail clinic potentially could be an important component of coordination of care aimed at reducing disease exacerbations, unnecessary hospitalizations and adverse drug interactions. If this vision were realized, the retail clinic phenomenon could be transformative for a vast number of patients in the United States,” she said.
But all Dr. Stream can see or hear is someone coming to take his job away from him.
I enjoyed reading your column (“Occupy Health Care,” May 21, 2012). … It did make me wonder how ordinary bench pharmacists could be empowered to help Medicare patients [know] about the [free annual wellness visit] physical benefit. It would be a great way to get more people treated, and it would be great for pharmacy.
— Bruce Kneeland, Royersford, Pa. , national account manager pharmacy at Epicor Software
Waiting rooms as educational tools
Digital health programming aired through a doctor’s office waiting room is becoming more prevalent, with more providers expanding their networks. It’s an opportunity for retail pharmacies to reach that captive audience satirized by comedian Jerry Seinfield: “There’s no chance of not waiting [in the waiting room.] That’s the name of the room,” he said as part of a rant on doctors. “They finally call you and it’s exciting … but you’re just going to the little waiting room.”
One company making a major push in this space is AccentHealth, a point-of-care media company featuring health education television content, which recently expanded its feature programming produced by CNN’s Medical Unit. One point of difference for AccentHealth: It is able to supplement its programming with local advertising. One obvious target for those ads is local pharmacies near the physician offices that are part of AccentHealth’s network.
“Because we’re a digital network, we can actually geo-locate our offices to our pharmacy partner’s stores and offer just these doctors’ offices, for example, that are within a 5-mile radius of that store,” noted Edith Hodkinson, president of AccentHealth’s media division. The messages can be tailored to identify the nearest pharmacies and include a short code patients can use to download directions.
AccentHealth collectively reaches more than 173 million viewers annually across more than 12,300 physician waiting rooms nationwide, including 9,800 general practitioner offices. The balance of the networks is split between OB-GYN waiting rooms (1,000) and pediatric waiting rooms (1,500).
In April, the network expanded its condition-specific networks to include arthritis pain, COPD, smoking cessation, gout, low testosterone, multiple sclerosis, osteoporosis and overactive bladder. The new networks are in addition to AccentHealth’s nine other condition-specific networks: allergy, mental health, asthma, diabetes, GERD, rheumatology, heart health, men’s health and senior women’s health.
On average, patients are in the doctor’s waiting room for some 27 minutes, Hodkinson noted. That’s almost one-third of the average time a person spends seeking medical care on a day that they need it.
AccentHealth research found that 90% of patients visiting a doctor’s office go shopping after their visit, and 64% of these viewers will purchase a prescription medication.