On-the-spot strep throat tests offered at some Shoppers Drug Mart pharmacies

A number of pharmacies are offering what appears to be a quick and easy way to find out if you have strep throat — but some experts are concerned about the safety of bypassing traditional laboratory testing.

The nasty bacterial infection is characterized by — among other things — throat pain, swollen tonsils and fever.

Typically, a doctor swabs your throat and you have to wait, and suffer with these symptoms, for 24 hours or more to find out the result. But drugstores in three provinces now offer the rapid on-the-spot strep test, and allows Alberta patients to walk out with a prescription without ever setting foot in the doctor's office.

Results available on-the-spot

At a Shoppers Drug Mart in the Kensington area of northwest Calgary, patients can have their throat swabbed right in the pharmacy for $15.

"In less than 10 minutes for the whole procedure, we can tell them if they are positive or negative for the strep," pharmacist Azita Rezaei said.

If the test comes back positive, a pharmacist like Rezaei can prescribe antibiotics right then and there.

"We've had positive feedback from people, families when they have small kids, and even adults," Rezaei said.

She says her pharmacy runs a handful of the rapid strep tests every week.

"They prefer to come to the pharmacy and get the test done because they say it saves them a lot of time and hassle," Rezaei said.

Some Shoppers Drug Mart pharmacists in Alberta, Nova Scotia and British Columbia have been offering the test since last November.

In Alberta, pharmacists can then write up a prescription.

The drugstore chain says it met with the Alberta College Of Pharmacists, the Alberta Pharmacists' Association, the College of Physicians and Surgeons of Alberta and Alberta Health to review the program before launching it.

A spokeswoman for the company said the program is win-win.

"We strongly believe that pharmacists offering these types of services help to provide earlier access to care for patients and a savings to the health care system," Tammy Smitham said.

Not everyone is convinced

While the service seems convenient, some physicians are skeptical.

"I can totally understand why patients are attracted to this sort of thing and why pharmacists want to offer it to their patients. The trouble is the accuracy," said Dr. Etienne Mahe.

Mahe is a clinical assistant professor at the University of Calgary's department of pathology and laboratory medicine.

Experts like Mahe worry about the sensitivity of rapid strep tests and the fact they are done without a detailed physical exam.

"Usually when these types of tests are used, they're used as part of a larger treatment or clinical algorithm, and that's the other element of my concern," he explained.

"If you're just using the test by itself and you're using it to direct therapy, you're probably going to make mistakes a lot, and that could actually have some pretty substantial consequences."

One concern, he said, is that a false positive can contribute to the over-prescription of antibiotics and antibiotic resistance. A false negative — leaving strep undetected — could lead to other life-threatening conditions, such as scarlet fever.

Newer tests appear more accurate

While rapid strep tests have been criticized in the past for being less sensitive, the test used by Shoppers Drug Mart has an accuracy rate of about 95 per cent, says an associate professor of medicine at the University of Alberta.

But the problem, according to Lynora Saxinger, is that there is no way to know if the test is performing the way it's supposed to.

"It would be good to know that the test has been evaluated in a real-world situation to make sure that it's adequate to make the decisions they want to make with it," Saxinger said.

No guidelines governing use of tests in drugstores

The rapid strep test is just one of a growing number of so-called point-of-care tests designed to fulfil consumers' demand for more control over their health care.

"Point-of-care testing is an emerging area," said Jeff Whissell, director of pharmacy practice with the Alberta Pharmacists' Association.

Whissell said the association does not yet have guidelines for the use of the tests but is working to address that.

"We've begun to research what kinds of tests are available and what conditions are required to do them appropriately," he said. "And in the future we'll be working to put together guidelines that support pharmacists in using point-of-care testing appropriately."

Technology not yet widely used

According to Alberta Health Services, the rapid strep tests are not used at any of its Calgary-area facilities, including hospitals and urgent care centres.

It is unclear, though, how many independent doctor's offices may be using the technology.

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