270974 Can pharmacy chronic disease screening services reach high-risk, vulnerable populations?

Monday, October 29, 2012

Crystal Fuller, PhD, MPH , Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Preston Garnes , Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Natalie Crawford, PhD , Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI
Alexis Rivera, MPH , Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Silvia Amesty, MD, MPH, MSEd , Center for Family and Community Medicine, Columbia University, College of Physicians and Surgeons, New York, NY
Alezandria Turner, PhD , Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Katherine Harripersaud, MPH , Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Background: Pharmacies have been rapidly expanding services beyond prescription sales into blood pressure screenings, vaccinations, and non-prescription syringe sales to injection drug users (IDUs) to reduce the spread of HIV. Herein, we report on healthcare access factors related to willingness to utilize chronic disease screening services in pharmacies in New York City.

Methods: IDU syringe customers, their peers, and walk-in customers were recruited by IDU peers and pharmacy staff in low-income neighborhoods to participate in a pharmacy-based study. An ACASI survey ascertained demographics, healthcare utilization, disease diagnoses, and willingness to receive pharmacy screenings (cholesterol, glucose, blood pressure, and HIV testing). Adjusted associations were calculated using log-binomial regression.

Results: Of 667 participants: 67.3% male, 86.2% Black/Latino/a, 71% reported past illicit drug use, 84% unemployed, and mean age 44.9 years. Willingness to undergo pharmacy-based chronic disease screening (71%) was associated with having health insurance (PR=1.16), hospital/medical office as usual source of care (vs. nowhere/ER) (PR=1.23), and prior chronic disease diagnosis/illness (heart disease, high blood pressure, high cholesterol, stroke or diabetes) (PR=1.15). After adjustment, willingness to undergo pharmacy-based prevention screening was independently associated with having a previous chronic disease diagnosis/illness (PR=1.12).

Conclusion: These data suggest a high proportion of a low-income, at-risk population willing to utilize pharmacy-based chronic disease screening services, particularly those with a prior chronic disease/illness. Pharmacies as venues for chronic disease screening and potential impact on morbidity/mortality in low-income communities warrants further study. Lack of interest in pharmacy screening among those without a prior chronic disease/illness also warrants further research.

Learning Areas:
Chronic disease management and prevention
Epidemiology

Learning Objectives:
To determine healthcare access factors related to willingness to utilize chronic disease screening services in pharmacies in New York City

Keywords: Access and Services, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator of the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.