A Healthy Future for Community Pharmacy: Lessons from Point-of-Care Testing Platforms

By Sarah Hakim MSc (BMSc, MSc) (1), ,
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A Healthy Future for Community Pharmacy

A Healthy Future for Community Pharmacy:
Lessons from Point-of-Care Testing Platforms in Canada and the United Kingdom

Introduction

In an era of escalating healthcare demands, community pharmacies have emerged as vital providers of accessible, cost-effective care. Programs like HealthTab® in Canada and Pharmacy First® in the United Kingdom (UK) exemplify the transformative potential of pharmacies in expanding chronic disease prevention and management, particularly for cardiovascular health and diabetes. Early data from HealthTab highlight its clinical benefits, yet Canada faces challenges in scaling these innovations due to inconsistent funding and policy support. By contrast, the UK’s Pharmacy First program demonstrates how robust policy frameworks and investment can amplify pharmacy-led innovations, as evidenced by HealthTab’s recent integration into NHS community pharmacy initiatives. This article explores the successes, challenges, and opportunities for advancing community pharmacy models globally, drawing lessons from Canada and the UK to inform a path toward pharmacy-led chronic disease care.

The Global Role of Community Pharmacies in Chronic Disease Management

Community pharmacists are increasingly recognized as essential frontline providers in chronic disease management worldwide. In the United States, over 90% of individuals live within five miles of a pharmacy, where pharmacists deliver critical services such as vaccinations, point-of-care testing (POCT), and chronic disease screening (American Pharmacists Association, 2023). Internationally, pharmacists are often the most accessible healthcare professionals, with evidence demonstrating their interventions improve clinical, economic, and humanistic outcomes (World Health Organization, 2023).

A meta-analysis of 39 randomized trials involving over 14,000 patients found pharmacist-led care reduced systolic blood pressure by approximately 7.6 mmHg in hypertensive patients (Santschi, 2014). In Canada, the RxEACH trial showed that pharmacist case-finding and prescribing reduced cardiovascular event risk by 21% compared to usual care (Tsuyuki, 2015). These findings, supported by organizations like the World Health Organization (WHO) and the International Pharmaceutical Federation (FIP), underscore the need for policy support and collaborative practice models to empower pharmacists in managing conditions such as diabetes, hypertension, and dyslipidemia (International Pharmaceutical Federation, 2022).

HealthTab: A Groundbreaking Initiative in Canadian Community Pharmacy

HealthTab is a POCT platform that equips Canadian pharmacists with tools for rapid, lab-quality screenings, including on-site HbA1c testing for diabetes. Integrated into pharmacy workflows, it provides real-time reporting, transforming pharmacies into convenient hubs for preventive care. A 13-week pilot across 40 pharmacies yielded significant insights:

Table 1: Key Findings from the Canadian HealthTab Diabetes Screening Pilot

Table 1

These results reveal a critical public health gap: 38% of participants lacked a regular family physician, yet detection rates for diabetes and prediabetes were nearly identical regardless of primary care access (18.2% vs. 18.5%). This suggests traditional healthcare settings miss many at-risk individuals, positioning pharmacies as vital access points for early detection (Papastergiou, 2024).

Economic and Public Health Benefits of POCT in Pharmacies

Pharmacy-led POCT offers economic viability and clinical effectiveness, particularly in early disease detection. Early intervention reduces long-term healthcare costs by identifying at-risk individuals before complications arise (NHS England, 2023). For example, NHS data estimate a £7.52 return for every £1 invested in pharmacy-led cardiovascular screening, driven by reduced emergency visits and hospitalizations (NHS England, 2023). With 90% of populations in developed nations living within five kilometers of a pharmacy, this accessibility enhances public health outcomes (International Pharmaceutical Federation, 2022). However, scalability hinges on sustainable reimbursement and integrated healthcare models.

Lessons from the UK: Pharmacy First and the Power of Policy Support

The UK’s Pharmacy First program empowers pharmacists to manage minor ailments, prescribe contraception, and screen for chronic disease risk factors, supported by government funding and standardized reimbursement (NHS England, 2024). By alleviating pressure on general practitioners (GPs), it strengthens primary care capacity while delivering cost-effective outcomes. HealthTab’s expansion into NHS initiatives further validates this model’s adaptability. The UK’s success contrasts with Canada’s fragmented landscape, where inconsistent funding and scope-of-practice variability hinder progress (Canadian Pharmacists Association, 2023).

Challenges to Scaling POCT in Canada

Despite HealthTab’s promise, scaling it across Canada faces significant barriers:

  1. Inconsistent Funding: Pharmacy services are tied to dispensing, with limited public funding for preventive care (Canadian Pharmacists Association, 2023).
  2. Scope-of-Practice Variability: Unlike the UK’s centralized framework, Canada’s provincial regulations differ, complicating national implementation (Papastergiou, 2024).
  3. Integration Gaps: Without shared electronic health records (EHRs), coordination with primary care remains limited (Tsuyuki, 2015).

Regulatory, Training, and Infrastructure Considerations

Successful POCT adoption requires evolved regulatory frameworks, pharmacist training, and infrastructure investment. The UK and Australia exemplify this through standardized reimbursement and training programs, enabling pharmacists to operate at their full scope (International Pharmaceutical Federation, 2022). In Canada, harmonizing scope-of-practice laws and integrating pharmacy data into EHRs are critical steps. Pharmacists need specialized training in test administration and patient counseling, supported by digital tools for seamless care coordination (Steben, 2018).

Policy Recommendations

  1. Sustainable Funding: Establish public funding for pharmacy-led preventive services.
  2. Harmonized Policies: Standardize scope of practice across jurisdictions.
  3. Integrated Networks: Link pharmacy services with broader healthcare systems via EHRs.
  4. Public Health Partnerships: Leverage pharmacies for chronic disease prevention. 

Conclusion

HealthTab’s detection of diabetes risk in nearly one-fifth of screened individuals underscores the potential of community pharmacies in preventive care. However, Canada’s fragmented policies limit scalability, while the UK’s Pharmacy First program offers a blueprint for success through investment and empowerment. By adopting these lessons, Canada and other nations can redefine pharmacies as trusted hubs for chronic disease management, enhancing accessibility, improving outcomes, and reducing healthcare system strain.

References

American Pharmacists Association. (2023). The role of pharmacists in public health. Retrieved from https://www.pharmacist.com

Canadian Pharmacists Association. (2023). Scope of practice for pharmacists across Canada. Retrieved from https://www.pharmacists.ca/pharmacy-in-canada/scope-of-practice-canada/

International Pharmaceutical Federation. (2022). Expanding the role of community pharmacists in chronic disease management. FIP Report.

NHS England. (2023). Economic impact of cardiovascular screening in community pharmacies. NHS Reports.

NHS England. (2024). Pharmacy First: Expanding the role of community pharmacy in primary care. NHS England Reports.

Papastergiou, J., Elsabakhawi, M., Lori, L., Potter, C., & Van Den Bemt, B. (2024). Community pharmacy-based HbA1c screening for early detection of diabetes and prediabetes. European Journal of Hospital Pharmacy, 31(Suppl 1), A119-A120.

Santschi, V., Chiolero, A., Burnand, B., Colosimo, A. L., & Paradis, G. (2014). Impact of pharmacist care in the management of cardiovascular disease risk factors: A systematic review and meta-analysis of randomized trials. Archives of Internal Medicine, 174(11), 1859-1868.

Steben, M., Wenger, L., Raman-Wilms, L., Schneider, E., Church, D., & Waite, N. (2018). Pharmacists as immunizers, their pharmacies and immunization services: A survey of Ontario community pharmacists. Canadian Pharmacists Journal (Ottawa), 151(4), 263-273.

Tsuyuki, R. T., Houle, S. K., Charrois, T. L., Kolber, M. R., Rosenthal, M. M., Lewanczuk, R., et al. (2015). Randomized trial of the effect of pharmacist prescribing on improving blood pressure in the community: The Alberta clinical trial in optimizing hypertension (RxEACH). Circulation, 132(2), 93-100.

World Health Organization. (2023). Community-based healthcare and its role in managing chronic diseases. WHO Report.

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Sarah Hakim MSc (BMSc, MSc) (1)
Sarah Hakim is a fourth-year Doctor of Pharmacy (PharmD) student at the University of Toronto, with a Master of Science in Medical Biophysics from the University of Western Ontario. Her academic and professional journey reflects a strong commitment to integrating research, clinical practice, and health system innovation to improve patient outcomes. Sarah’s early scientific training at the Schulich School of Medicine & Dentistry laid the foundation for her interest in translational medicine and evidence-based care. Her graduate research focused on rare diseases and molecular imaging, and she was recognized as a Molecular Imaging Scholar by the World Molecular Imaging Society. Her work also earned her the prestigious Canada Graduate Scholarship – Master’s (CGS-M) from the Canadian Institutes of Health Research, as well as the Western Graduate Research Scholarship. Sarah aspires to lead practice innovations that promote equitable access, personalized care, and improved health outcomes across the continuum of care.
Sotiris Antoniou, BPharm(Hons), MSc, PhD (1)
Mr Sotiris Antoniou is Consultant Pharmacist at Barts Heart Centre, part of Barts Health NHS Trust. Combined with his role as Lead Cardiovascular Pharmacist for UCL Partners supports medicines optimisation across the health economy to optimise patient outcomes and address unmet local needs. He is an independent prescriber and is currently chair of the cardiac committee for United Kingdom Clinical Pharmacy Association (UKCPA). He is chair of the DRM-foundation that supports the international Pharmacist Anticoagulation Taskforce (iPACT). A group aimed to improve pharmaceutical care around anticoagulants, by providing background materials and stimulating pharmacists to provide appropriate care to their patients. He has published extensively in the medical press and has a particular interest in improving anticoagulation for stroke prevention in atrial fibrillation. Sotiris has been successful in obtaining a Lord Darzi funded fellow to ‘co-design and test a new referral pathway for people with atrial fibrillation with community pharmacists’ with the aim to support individuals' understanding of their condition and their therapy with the ultimate aim of optimising adherence. Mr Antoniou has served on many NICE development groups including Unstable Angina/NSTEMI guideline, stable angina and STEMI guidelines and is a current NICE TA member of the highly specialist technology appraisal group. He is also a member of the London Strategic Clinical Network Cardiovascular Leadership Group and NHS England Medicines Optimisation Intelligence Group meeting. Sotiris is also an honorary senior research associate at UCL School of Pharmacy.
John Papastergiou, BScPhm, PhD (1)
John Papastergiou, a 2002 graduate from the Leslie Dan Faculty of Pharmacy at the University of Toronto, embarked on an illustrious career that has seen remarkable achievements and contributions to the field. Initially serving as a staff pharmacist at Sunnybrook Health Sciences Center, John later transitioned to Shoppers Drug Mart in 2005, acquiring his first store at Pape and Danforth. Today, he owns and operates four thriving locations in downtown Toronto. In 2014, John attained an appointment as an adjunct assistant professor at the School of Pharmacy, University of Waterloo, and later in 2016, he was cross-appointed at the Leslie Dan Faculty of Pharmacy, University of Toronto. His academic journey culminated with a PhD from Radboud University in the Netherlands, focusing on point-of-care diagnostic testing and pharmacogenomics. Beyond managing a successful business, John leverages his clinical research background to redefine the role of community pharmacists. His belief in their unique position to actively screen and monitor patients for chronic diseases led to the implementation of one of the first frontline community pharmacist-directed pharmacogenomics clinics in Canada. Notably, his work in this domain secured the first prize at the 76th FIP World Congress of Pharmacy and Pharmaceutical Sciences in Buenos Aires, Argentina. Over the years, John has received numerous accolades, including being named the Shoppers Drug Mart Associate of the Year in 2012. In 2014, he was honored with the OPA Mentorship Award and named CPhA Canadian Pharmacist of the Year. The accolades continued in 2016 with the OPA Voice of the Profession Award and the Pharmacy Practice Commitment to Care Award for Overall Patient Care. In 2019, he was recognized as one of the top 100 healthcare leaders globally by the International Forum on Advancement in Healthcare, along with receiving the OPA Award for Excellence in Research and Academia. In 2020, he proudly accepted the inaugural Leslie Dan Faculty of Pharmacy, University of Toronto Alumni Leadership Award.

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