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

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.