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From dispensing to diagnosis

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From dispensing to diagnosis

Many people may still be unaware that they can get health checks and diagnostic services in community pharmacies, as Sarah Welsh explains…



In a fast-paced world, it’s not surprising that the general public is demanding quicker and easier ways to treat minor ailments and monitor certain conditions.

However for many, visiting the GP is either inappropriate or not possible due to time constraints or difficulty getting an appointment, so highlighting the services community pharmacies offer has never been more important.

It would seem intentions are good but the general public is slightly misinformed when it comes to knowing where to turn for their medical needs. According to the Self Care Nation report, although there are 11,674 community pharmacies in England alone, few people are asking for advice when visiting them to pick up prescriptions or making use of the wider health services they offer.

“In Lancashire pharmacists are raising their profile, offering health checks at public events such as village fairs,” explained pharmacist Thorrun Govind.

“Talking to people face to face is a great way to educate people about what community pharmacists can help with and encourage them to seek advice from them in the future.”

Community pharmacists are in the ideal position not only to promote the services they offer but give support to patients who don’t feel entirely confident choosing an appropriate product for themselves.

“If they haven’t experienced a set of symptoms before or are concerned about possible interactions with other medicines they are taking for example, they can seek advice from a pharmacist,” said John Smith, chief executive of the Proprietary Association of Great Britain.  


Lung disease

With approximately 12 million people in the UK diagnosed with lung disease, there are plenty of people in need of advice and reassurance from their community pharmacist on how to manage their condition and medication.

A key intervention is ensuring correct inhaler technique. In fact, according to the Royal Pharmaceutical Society, studies in community pharmacy settings focusing on inhaler technique resulted in a significant improvement in asthma control.

“In Leeds, we’ve previously commissioned community pharmacies to provide a COPD service where patients received two consultations eight to 12 weeks apart with a pharmacist or pharmacy technician,” said Toby Capstick, a Royal Pharmaceutical Society spokesperson and consultant pharmacist in respiratory medicine at Leeds Teaching Hospitals NHS Trust.

“This service resulted in a 22% drop in unsatisfactory inhaler technique and a significant improvement in COPD health status. The evaluation shows that 95.3% of patients felt they had a better understanding of COPD following the consultations, and 95.8% of patients felt they understood their different medicines following the consultations.”

Community pharmacists need to be proactive in their approach to discussing things such as lung health and communicating the services and tests they can offer to those who smoke or repeatedly purchase cough medicines.

“Speak to local GP practices and community respiratory nursing teams about a joined-up service and how to support their services,” Capstick suggested.

“There’s data showing that COPD case-finding by community pharmacists using micro-spirometry potentially provides cost savings and improves quality of life, so pharmacies in high-prevalence areas may want to work with commissioners to trial similar services.”


Sore throats

Throat conditions account for a large numbers of people visiting their GP, usually unnecessarily. It has been found that a test and treat service for streptococcus A in community pharmacies could decrease GP consultations for sore throats and reduce antibiotic prescriptions.

A pilot study of a test and treat service in a pharmacy setting found that out of 149 patients who underwent throat swab testing just 36 tested positive for group A streptococci and received antibiotics from the pharmacist.

Innovations in technology mean pharmacists can achieve quick results, in some cases as little as 15 minutes, when compared to laboratory culture of throat swabs, making them ideal for potential use in a primary care setting such as a community pharmacy.

The National Institute for Health and Care Excellence said: “Point-of-care strepA tests are designed to give a more accurate confirmation of the presence of bacterial infection than clinical evaluation, including clinical scoring systems.

“This is aimed at improving antibiotic prescribing in line with local guidelines, which may help to reduce antimicrobial resistance. The quick 'time to result' of the tests compared with laboratory testing aims to help treatment decisions to be made during a single GP or community pharmacy visit, without the need to wait for laboratory tests results.”


Blood pressure

Every year 10 million lives are lost due to raised blood pressure and only half of those people were aware of their condition. Therefore offering blood pressure monitoring to both the undiagnosed and diagnosed is essential to prevent needless deaths.

Community pharmacists are in the ideal position to offer such a service to customers which is not only quick but convenient too. In addition to testing on site, community pharmacists should consider offering a range of home blood pressure monitors.

“To enable self-monitoring on a regular basis, equipping individuals with the tools to take action and increase their chances of living longer and healthier lives plays a crucial role,” said an Omron Healthcare spokesperson.

Even the most advanced home blood pressure monitors are easy to use, resulting in accurate readings. Connectivity is a new development in this arena, allowing users to track their progress with their smartphones.

There are even portable devices on the market, such as one-piece upper arm blood pressure monitors and a whole wrist-type range, which adapt to a variety of lifestyles.

“Connected mobile apps now enable people to track their activity and relevant health history, meaning valuable personal data insights are easily accessible, at the touch of a fingertip,” Omron said.



Although community pharmacists may offer a range of health checks to their customers, some may still prefer carrying out tests in the privacy of their own home.

However, this doesn’t automatically relegate pharmacists to the side-lines - they can still advise customers which self-test kits to choose and help them interpret the results.

“As technology has developed the option for self-testing has become a reality,” said Jaime Perkins, UK sales director at Biosure.

“This provides convenience and instant results for consumers whilst relieving pressure on already overburdened healthcare providers.”

When it comes to extremely sensitive issues such as STDs, many patients prefer to purchase a home test from their local pharmacy. In fact, according to a recent survey by BioSure, 60% of responders said they would prefer to purchase an HIV self-test from a community pharmacy.

These easy-to-use test and achieve results in just 15 minutes and community pharmacists can offer support and guidance with results.

Whether customers need treatment for a sore throat, advice about blood pressure or help managing their diabetes, community pharmacists are in the ideal position to offer them a convenient way to deal with their issues.

By highlighting the support they offer to customers, community pharmacists will begin to build trust and broaden their service uptake within the community.



What are independents’ competition up to?

LloydsPharmacy recently launched a sore throat service to identify streptococcus A infections in 600 of its stores across the UK.

The test, which costs £4.99, is available to anyone aged 18 or over, with LloydsPharmacy’s parent company Celesio insisting the service will “reduce the burden on GPs whilst supporting the growing issue of antibiotic resistance.”

The test, the company said, “offers 98% accuracy and means that instead of waiting for a GP appointment, patients can visit their local community pharmacist for both screening and antibiotics (if required).”

If the patient’s sore throat needs antibiotics, the pharmacist will supply them, the walk-in service which includes a questionnaire, examination and mouth swab test for a bacterial throat infection taking a few minutes, according to Celesio.

“Antibiotics will be provided to those patients who positively test for Strep A and meet the inclusion criteria as outlined in the Patient Group Direction,” the company said.

“For those patients who do not require antibiotics, the relevant over-the-counter product and/or advice will be supplied to provide relief from symptoms.”

Pareena Patel, a pharmacist based in a branch of LloydsPharmacy in Worcestershire, said: “Around 85% of sore throats are viral and so are not treatable by antibiotics. Almost a third of people still visit their GP with a sore throat yet the vast majority would be better off seeing a pharmacist as it is a condition which requires rest, over-the-counter medications to help manage symptoms and antibiotics if appropriate, all of which can now be provided in pharmacy.”


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