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Expert Q&A: Role of Pharmacists in COVID-19 Care, Prevention Continues to Evolve
Pharmacists play a key role in COVID-19 management by educating patients on treatment, monitoring drug interactions, promoting vaccination, and addressing hesitancy.
In an interview with Pharmacy Times®, Corey Frederick, PharmD, BCPS, BCIDP, CPh, ambulatory care infectious diseases clinical coordinator at Baptist Health South Florida, discussed the evolving role of pharmacists in diagnosing, preventing, and managing infection with SARS-CoV-2, the virus that causes COVID-19.
Pharmacists have played an increasing role in managing COVID-19 infections since the beginning of the pandemic. | Image Credit: © AK Coop/peopleimages.com - stock.adobe.com
Frederick explains how pharmacists' roles have evolved from answering early treatment questions to actively managing antiviral therapies, monitoring drug interactions, and promoting vaccinations. With at-home and point-of-care testing widely available, pharmacists ensure accurate diagnosis and guide patients on symptom management. Pharmacists also play a crucial role in addressing vaccine hesitancy by providing evidence-based recommendations, according to Frederick.
Pharmacy Times: How has the role of pharmacists in COVID-19 diagnosis and treatment evolved since the early days of the pandemic, and what key responsibilities do they have today?
Corey Frederick, PharmD, BCPS, BCIDP, CPh: The role of pharmacists in COVID-19 care has changed dramatically since the early days of the pandemic. In 2020, there were a lot of questions about what, if any at all, treatment options were effective against the SARS-CoV-2 virus. Pharmacists reviewed the latest evidence, answered drug-information questions from prescribers and patients, and recommended effective over-the-counter treatments for symptomatic care. In 2025, effective treatments and vaccines are now both widely available. Pharmacists now play a key role in educating patients about appropriate treatment options, monitoring for drug-drug interactions and renal dose adjustments, and encouraging patients to receive COVID-19 vaccinations based on the latest CDC recommendations.
Pharmacy Times: With the continued availability of at-home COVID-19 tests and point-of-care testing in pharmacies, what best practices should pharmacists follow to ensure accurate diagnosis and patient education?
Frederick: Pharmacists can advise patients on how to perform the test based on the specific product they may be using. Pharmacists can help counsel patients on proper technique for either themselves or friends and family members. Providing patients with clear instructions on how to interpret test results is vital, including the potential for false-negative results if the test is taken too soon following potential COVID-19 exposure. Additionally, pharmacists can instruct patients on how to prevent spreading COVID-19 to others in the instance they do test positive.
Pharmacy Times: What are the latest updates on antiviral treatments for COVID-19, and how can pharmacists help optimize their use, especially in high-risk populations?
Frederick: Treatment for COVID-19 can be divided into two groups: hospitalized and non-hospitalized patients. The most prevalent treatment options for non-hospitalized COVID-19 patients are nirmatrelvir-ritonavir (Paxlovid; Pfizer) and molnupiravir (Lagevrio; Merck). National Institute of Health (NIH) guidelines recommend nirmatrelvir-ritonavir as a “preferred therapy.” For those patients that may be unable to take nirmatrelvir-ritonavir due to a significant drug-drug interaction(s), molnupiravir is recommended as an “alternative therapy.” Both are recommended for use in patients with high-risk for severe COVID-19 disease progression. For hospitalized patients requiring supplemental oxygen, intravenous remdesivir (Veklury; Gilead) is recommended. Dexamethasone is also recommended for patients requiring significant supplemental oxygen demands. Pharmacists can play a vital role in ensuring COVID-19 medications are appropriately prescribed based on the latest evidence-based recommendations. With nirmatrelvir-ritonavir, pharmacists can ensure prescribed patients are counseled on any significant drug/drug interactions and receive the applicable dose based on their renal function.
Pharmacy Times: How can pharmacists play a more proactive role in addressing COVID-19 vaccine hesitancy and ensuring patients receive recommended booster doses?
Frederick: Pharmacists can address patient vaccine hesitancy by providing objective, fact-based evidence supporting use of COVID-19 vaccines. Pharmacists have historically been ranked high among the most trusted medical professionals and are generally regarded in high esteem by the community. Leveraging this trust while providing evidence-based recommendations can help overcome vaccine hesitancy in patients. Additionally, pharmacists should listen to patients’ specific concerns and address them directly.
Pharmacy Times: With COVID-19 increasingly being managed like other respiratory viruses, what counseling strategies should pharmacists use to guide patients on symptom management, treatment access, and when to seek further care?
Frederick: Widespread immunity, circulating variants, and access to vaccines and treatment options have changed the landscape of COVID-19 so that most COVID-19 patients can be managed symptomatically on an outpatient basis. When counseling COVID-19-positive patients, ensure they take appropriate infection prevention precautions so as not to spread the virus to pharmacy staff members and other patients present.
Additionally, pharmacists can remind patients that since COVID-19 is caused by a virus, there is no need for antibiotics for treatment. Next, pharmacists can assess what symptoms the patient is currently experiencing and recommend applicable over-the-counter therapies. For example, if a patient is struggling with a persistent cough, guaifenesin (Mucinex) can be recommended. Acetaminophen or ibuprofen should be recommended for patients with myalgia or fever. Those with nasal congestion and/or rhinorrhea can take an antihistamine with or without a decongestant. Regardless of a patient’s specific symptoms, pharmacists can help alleviate any COVID-19 related anxiety after testing positive by answering any questions or concerns they may have.
Pharmacy Times: Looking ahead, what do you see as the biggest challenges and opportunities for pharmacists in managing COVID-19 and other emerging infectious diseases?
Frederick: Like mentioned earlier, one of the biggest challenges pharmacists face is vaccine hesitancy and a relaxed attitude towards the threat of infectious diseases. The threat of antimicrobial resistance is a significant public health crisis, estimated to cause 39 million deaths between 2025 and 2050 based on a recent study’s estimate. Pharmacists can help patients do their part in combating this threat by ensuring they understand antibiotics are only needed when they have a bacterial infection. A great way for patients to avoid bacterial infections is to ensure they remain up to date on all recommended vaccinations.1
