2026-01-20 16:23:00
The pharmacist’s role in medication therapy management (MTM) continues to evolve. Test-and-treat services are a prime example. Pharmacists played an integral role in these services when the COVID-19 pandemic began, under the Public Readiness and Emergency Preparedness Act. Which point-of-care testing (POCT) pharmacists can perform and whether they can prescribe medications vary by state.1 Typical POCT opportunities include COVID-19, Streptococcus, influenza, and respiratory syncytial virus (RSV). Pharmacists play a vital role in test-and-treat programs through MTM services within the community pharmacy practice setting.
Test and Treat and MTM
According to the National Alliance of State Pharmacy Associations, pharmacists in 42 states and Washington, DC, can administer POCT as of July 2025.1 Additionally, pharmacists practicing in 30 of those states and Washington, DC, can prescribe medication based on the POCT results.1 Common medications that pharmacists may prescribe include nirmatrelvir/ritonavir (Paxlovid; Pfizer), oseltamivir (Tamiflu; Genentech), baloxavir marboxil (Xofluza; Genentech), and zanamivir (Relenza; GSK). West Virginia recently passed legislation in 2025 allowing pharmacists to test and treat for COVID-19, influenza, and RSV.1
There are a variety of test-and-treat certificate programs for pharmacists interested in providing these services. For instance, the American Pharmacists Association and the University of Florida College of Pharmacy have developed an 8-hour program for pharmacists and pharmacy students.2 The program is accredited by the Accreditation Council for Pharmacy Education (ACPE) and includes self-study, live seminar, and post-live training.2
The 4 modules review vital information for pharmacists when treating patients, including the following:
- Pharmacist opportunities for POCT.
- POCT overview and regulations.
- Physical assessment in patient care, including collecting medical history, allergies, and symptoms.
- Taking vital signs, such as blood pressure, pulse rate, body temperature, oxygenation, and respiratory rate.
- Conducting throat and skin exams.
- Preparing and performing POCT, including throat swab, nasal swab, and finger stick blood collection.
- Testing, treating, and managing strep, influenza, COVID-19, and urinary tract infections.
- Determining whether follow-up testing is needed.
- Identifying when it is appropriate for a physician referral.
- Developing a physician protocol agreement, including documentation and communication procedures.
Research shows pharmacists play an important role in POCT and treatment for respiratory infections.3 Neighborhood pharmacies can help reduce health disparities by providing timely access to POCT and treatment options. One study, with POCT and treatment under a collaborative pharmacy practice agreement (CPPA) as the primary objective, compared uninsured and insured patients and individuals with and without an established primary care provider (PCP).4 The secondary objective examined patient satisfaction with these services. The study was conducted at the 2 locations of an independent community pharmacy in Gallatin, Tennessee: Perkins Drugs and Gift Shoppe,4 both of which have since closed. Approximately 10% of the county’s residents were reported to be uninsured.4
Pharmacists at the community pharmacies entered a CPPA with a local physician to perform influenza and strep tests. Pharmacists developed a decision tree to evaluate symptoms, identify comorbidities, and assess vital signs.4 The CPPA allowed pharmacists to prescribe either antivirals or antibiotics based on CDC guidelines if patients tested positive for influenza or strep. During the 5-month study, pharmacists performed POCT on 73 patients for influenza or strep.4 Out of these patients, 24 (33%) did not have a PCP.4 Additionally, 31 (42.5%) of the study participants were uninsured.4
There was no statistically significant difference in pharmacy POCT use between the insured and uninsured groups (P = 0.12).4 More patients with an established PCP used the pharmacy services than individuals who did not have an established one (P = 0.02).4 Additionally, 98% of the patients contacted for follow-up were satisfied with the pharmacy POCT and treatment services and would use them again.4 This study highlights the critical role community pharmacists play in POCT and treatment services.
MTM Spotlight
In an email interview with Pharmacy Times, Charlene M. Daumke, a pharmacy manager at Walgreens in Port St Lucie, Florida, discussed the pharmacist’s role in test-and-treat programs. Walgreens provides POCT and treatment services for COVID-19 and influenza. Walgreens pharmacists can prescribe and dispense nirmatrelvir/ritonavir, oseltamivir, baloxavir marboxil, and zanamivir under a protocol with a physician.
Daumke detailed the training she completed to perform test-and-treat services. “In the state of Florida, for the initial certificate, we were required to complete a 20-hour ACPE-accredited course, which included 8 hours of live continuing education with a skills assessment. We also completed various proprietary operational courses and taught swabbing technique to our technicians. To maintain the certification, we complete annual bloodborne pathogen and regulated medical waste trainings as well as a 3-hour ACPE accredited-recertification course each licensure renewal period,” said Daumke.
