Mary Beth Dameron, PharmD, BCACP
Erik Gunderson, PharmD, BCPS
Amanda Applegate, PharmD, BCACP
This resource page provides timely information regarding screening, testing, and treating COVID-19/severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) particularly in the ambulatory care and community practice settings. This resource page will be updated every few weeks as new information emerges. If there are additional resources related to COVID-19/severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that you think would benefit ambulatory care practitioners, please contact us at iforumrx@gmail.com.
LAST UPDATED: May 11, 2022
Centers for Disease Control and Prevention (CDC) Guidance and Recommendations Description: The Centers for Disease Control and Prevention (CDC) lists symptoms one should be aware of when assessing for risk of COVID-19, rare but associated symptoms, and emergency/alarm symptoms. Interim Clinical Considerations for use of the COVID-19 Vaccination Description: Everything you want to know about the vaccines, from what to do with someone who has received a vaccine as a part of a clinical trial to evaluating possible adverse events – any question you have about the use of the vaccines is probably answered here! Description: Having someone over to visit or helping a patient plan a gathering? Use this interactive tool to see what combination of steps you can take to keep everyone safest! Isolation and Quarantine Calculator Description: Were you or a patient recently exposed to someone who has tested positive for COVID-19? Did you test positive on a home test? Use this calculator to help determine isolation or quarantine dates – don’t forget to follow the masking guidance that follows isolation, as someone who has tested positive is contagious for at least 10 days, even if they can return to work with a mask on day 6! Guidance for Mass/Off-site Immunizations during COVID-19 Description: With flu shot season upcoming, pharmacies will need to rethink how to best serve the needs of their community while protecting both staff and their patients. CDC Recommendations for Community-Related Exposure Description: Have you or someone you know been exposed to an individual with known or suspected COVID-19? Based on community exposure to symptomatic or asymptomatic individuals, the CDC has developed public health recommendations geared towards taking necessary precautions to minimize spread of the virus. Are you classified as health care personnel, a frequent (or even not-so-frequent) traveler, or an essential worker? If so, separate guidance is available for you – but have no fear – you can find the recommendations for those populations through this resource as well. CDC Recommendations for Cleaning and Disinfection for Community Facilities Description: At some point, a person in your pharmacy will test positive for COVID-19. Work with local health departments and use this guidance to assist with cleaning and ensuring that the workspace is safe for employees to return to work. Bonus: EPA List N: Disinfectants for Use Against SARS-CoV-2 Description: List N shows what disinfectants are approved for use against different types of pathogens – this resource reveals what is approved to kill emerging pathogens such as SARS-CoV-2 and how long it needs to stay on a surface to kill it. People at Increased Risk for Severe Outcomes Description: The CDC has updated their list of people at increased risk of poor outcomes to remove a specific age cutoff and added several disease states. Pharmacists can use this to help focus counseling and public health efforts on people who fall into these populations. COVID-19 Therapeutics Description: Search for available therapeutics in your area – narrow by state or therapy type to find monoclonal antibodies, Evusheld, and oral antivirals. Clinical Decision Aid for COVID-19 Outpatient Therapeutics Description: Use this chart to help determine which of your available therapeutics options is right for your patients. COVID-19 Therapeutics Side by Side Description: This document gives an overview of all currently approved COVID-19 therapies, with links to fact sheets, information about the mechanism of action, side effects, and authorized use. National Institute of Health COVID-19 Treatment Guidelines Description: In depth guideline for treating both inpatient and outpatient COVID-19 cases. Description: Learn more about the test to treat initiative and apply to sign up using the contact us at the bottom right of the page. American Pharmacists Association (APhA): 15 on COVID-19 CE Series Description: To encourage pharmacists stay up-to-date with the latest COVID-19 research and practice guidance, the American Pharmacists Association (APhA) has developed a series designed to provide education about COVID-19 through a series of 15 to 20 minute online episodes. Each episode is concentrated on a specific topic (think clinical efficacy of proposed therapies, point of care testing, etc.) and helps to separate fact from fiction and hypothesis from rumor. This, in turn, will ensure pharmacists are able to effectively answer questions from patients and other health care providers. Did we mention that each episode is approved for CPE for pharmacists and pharmacy technicians? Podcast. Approaches to COVID-19 Vaccines and Antivirals N Engl J Med 2020; 382:e58 DOI: 10.1056/NEJMe2012889 Description: Do you have a long commute on the way to work? Are you looking to pass the time while you’re quarantined at home? Listen to Dr. Eric Rubin and Dr. Lindsey Baden as they discuss an overview of the approach to developing effective immunizations and medications… and where we stand now. Description: This resource provides detailed recommendations surrounding drug-drug interactions with experimental COVID-19 therapies. Trust us, you will want to use your browser’s “find” function when searching for drug names on this site. American Society of Health-System Pharmacists (ASHP): Assessment of Evidence for COVID-19-Related Treatments Description: Curious about evidence available to support current approaches related to treatment and care of COVID-19? The American Society of Health-System Pharmacists (ASHP) has compiled a detailed assessment outlining current trials or clinical experience to evaluate the role (or lack thereof) of certain medication therapies in the treatment and management of COVID-19. Be sure to check back regularly – this evidence table is emerging and rapidly evolving because of ongoing research.
Point of Care Testing and Personal Protective Equipment Food and Drug Administration (FDA): Emergency Use Authorizations Description: This resource identifies current and terminated emergency use authorizations (EUAs) that improve access to diagnostic and therapeutic medical devices needed during public health emergencies. Broken down by category of EUA with fact sheets and instructions for health care providers and facilities as applicable, you may find this site beneficial in assessing the legitimacy of COVID-19 test kit approval claims. In the Test Kit Manufacturers and Commercial Laboratories Table, you can sort by Authorized setting – a kit labeled with a “W” is a point of care test able to be used in a site with a CLIA waiver. National Community Pharmacists Association (NCPA): Opportunities for Pharmacy Testing during COVID-19 Webinar Slides: http://www.ncpa.co/media/webinar/Opportunities-for-Pharmacy-Testing-during-COVID-19.pdf Description: Curious about COVID-19 point-of-care testing and opportunities for implementation of testing within your practice site? This webinar provides an in-depth overview of point-of-care testing options (and how to identify the not-so-legitimate ones) and guidance for expansion of testing. Don’t have time to listen to the webinar? No problem – find the slide deck with pertinent information discussed included here as well. CDC Strategies to Optimize the Supply of PPE and Equipment Description: This addresses the need to first conserve PPE, then potentially how to reuse if necessary. Especially applicable is the N-95 Respirator section, which has an excellent table that addresses the level of risk with what type of mask should be utilized. If an N-95 is indicated (such as for doing nasopharyngeal swabs!), it addresses how to perform qualitative fit testing. OmniSys – Point of Care Testing and Billing Resource Description: Interested in offering COVID-19 testing at your pharmacy but are unsure of where to begin? This resource offers step-by-step COVID-19 training for any pharmacist in the country at no cost. Items covered include, but are not limited to the following: accessibility of COVID-19 test kits, payers that offer reimbursement, administration of a nasal swab, etc. There is one caveat – you have to sign up and request access to the training – but keep in mind that it is free for the time being. FDA 501(k) Premarket Notification Search Description: As your pharmacy or clinic is looking for devices such as thermometers or pulse oximeters to use or sell to patients, check their claims of “FDA approved” against this database to ensure you are getting a legitimate product. There are a lot of fakes out there such as food or surface thermometers dressed in white to pose as a non-contact human thermometer. CLIA Waiver Application CMS Form 116 Description: Once you find a test kit that is approved for point of care testing, it is considered CLIA-waived. You will need to have a CLIA waiver from your state lab agency on file before you can begin performing CLIA waived tests. Fill out the attached form with the tests you intend to perform, submit to your state’s lab agency, and once approved, pay $180 every 2 years to maintain the waiver. Note that the requirements for obtaining a waiver vary from state to state. Telehealth United States Department of Health and Human Services: Telehealth Resources Description:What if we don’t have to choose between patient-centered care and practicing social distancing? Telehealth services enable patients to receive the care they need from the comfort (and safety) of their own homes. But, what if a patient has never heard of the phrase “telehealth” before or what if you are unsure of how to integrate telehealth into your practice? Is it HIPAA compliant? This website is a great resource for both patients and health care providers to assist with orientation to the latest form of healthcare. Center for Connected Health Policy: COVID-19 Related State Actions Description: For state-specific actions to remove policy barriers and improve access to telehealth services during the COVID-19 pandemic, look no further. Center for Medicare and Medicaid Services (CMS): Reopening Facilities to Provide Non-emergent Non-COVID-19 Health Care: Phase I Update: Reopening Facilities to Provide Non-emergent Non-COVID-19 Health Care: Phase II Description: As areas stabilize in the future, patient care that has temporarily been postponed will be resumed (cue chronic disease state management and preventive care). While maximizing use of all telehealth modalities remains highly encouraged by CMS, this resource outlines recommendations to help guide healthcare systems and facilities regarding resuming in-person care of non-COVID-19 patients in areas with low incidence of COVID-19 disease. Billing & Reimbursement Center for Medicare and Medicaid Services (CMS): Frequently Asked Questions for Health Care Providers about Medicare Payment Description: Are you currently practicing as an ambulatory care pharmacist in a clinic or a federally qualified health center (FQHC)? The Centers for Medicare and Medicaid Services (CMS) has developed a document that includes frequently asked questions about Medicare fee-for-service billing. Are you offering telehealth visits for your patients? Clinicians are now able to provide more services via telehealth to ensure optimal patient-centered care while mitigating the risk of spreading COVID-19. Find the answers to common questions about telehealth services beginning on page 20 of the frequently asked questions document. Bottom line: CMS has implemented a number of new regulatory flexibilities for providers and services during this public health emergency. HRSA COVID-19 Claims Reimbursement Description: If your pharmacy has provided or is planning on providing COVID-19 testing or treatment to uninsured individuals, you can get set up and bill the Health Resource and Service Administration for reimbursement of services provided. You will need to document that you confirmed that the patient does not have access to insurance and payments will be on par with CMS rates for services. Description: This MLN Matters brief explains how to temporarily enroll your pharmacy as a lab to be able to bill Medicare Part B for active case testing. If your state practice laws allow you to order labs, this is your route to billing Medicare Part B! It has been clarified that if your pharmacy is already registered and has a PTAN for immunizing, you still need to register as a lab and get an additional PTAN to be able to bill for COVID/flu testing. Patient Education Description: Patient friendly handouts in English and Spanish explaining the HRSA program making COVID vaccines, testing, and care free for everyone living in the US. Coronavirus Print Resources – Information for Patients Description: Patient-friendly (though sometimes wordy) documents that can be printed out. This has many different handouts ranging from self-care for COVID-19 symptoms at home (many languages!) to appropriate hand washing technique. Description: Not patient-friendly in any way, but good information to help you help them! In-depth guidance from the WHO on facial coverings and mask usage in both healthcare settings as well as in the general public. Use the recommendations to help guide patients in choosing a facial covering that is appropriate for their personal risk level as well as based on the activities they will be doing.
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iForumRx.org is a web-based community of practice designed to inform ambulatory care pharmacy specialists, pharmacy residents, and student pharmacists about high-quality, practice-changing evidence.