There is a whole range of illnesses that can strike children at any time: from asthma and depression through to chicken pox and measles. With community pharmacists being promoted as a first port of call for health issues, Sarah Welsh explores the best way to offer parents and children the support and advice they need.

One of the most common illnesses of childhood is asthma with one in 11 children in the UK suffering from the disease, which equates to three in every classroom. One child is admitted to hospital every 20 minutes because of an asthma attack, resulting in three deaths a day – two thirds of which are preventable, according to Asthma UK.

The best way to manage a child’s asthma and reduce the risk of an asthma attack, is to ensure they are using an up-to-date action plan, says Asthma UK. The plan should include information about what medicine is required and what to do in case of an asthma attack.

Community pharmacists are in a good position to help parents understand which medicines their child needs, what they are for and when to take them. With the British Lung Foundation claiming up to 90% of asthma suffers have poor inhaler technique there is a clear need for education.

Parents should be encouraged to share their child’s action plan with any care givers so that they can recognise symptoms and know what to do should the child have an asthma attack.

Many community pharmacists offer inhaler technique services, which allow them to check that patients are using their inhalers effectively to manage their asthma symptoms.

“If 90% of patients don’t get the right amount of medicine in the right part of their lungs this can result in poor disease control, more side effects and more hospital admissions,” says Abraham Khodadi (aka Abraham the pharmacist).

Some children may have been taking asthma medication for years, but it’s likely they could have picked up bad habits, which could affect their technique. To ensure that all patients are getting the full benefit of their medication offering a review of their technique could be beneficial.

“Community pharmacists are ideally placed to help monitor asthma control,” says explains Dr Andy Whittamore, clinical lead at Asthma UK. “Using a reliever inhaler three or more times per week is a sign of poor asthma control. Anyone using more than one reliever inhaler per month should have their asthma control reviewed.”

Community pharmacists should always try to show children and their parents how to use the inhaler, even if the doctor has already done so. This will not only ensure they know how to use it correctly, but build their confidence and give them a chance to ask any further questions.

“I always engage with the children as they are the ones who will be using it,” says Thorrun Govind, community pharmacist at Sykes Chemist. “When I show parents how to use the spacer device for younger children, I give them distraction tips to make the process easier for them as it can sometimes be a struggle.”

Asthma UK has a number of resources available for community pharmacists which can be downloaded from its website. These include written asthma action plans and peak flow diaries.

Mind’s eye

In an age when young people are subjected to a wide range of influences, thanks to social media and electronic devices, the number of cases of children with mental health issues is on the rise.

“We’re currently in a mental health crisis for children and young people with an estimated three children in every classroom having a diagnosable mental health problem and many more who go through difficult times,” warns Matthew Blow, policy manager at charity YoungMinds.

Today’s youth are under a tremendous amount of pressure from stress of school work, bullying and body image issues – all of which can be exacerbated by the virtual world that they all seem to be deeply immersed within. 

“Social media can have many benefits for young people, helping them to express themselves and offering them the opportunity to build communities that they otherwise wouldn’t be able to,” says Nick Harrop, campaigns manager at YoungMinds. “However, it also comes with the pressure to establish a personal ‘brand’ from a young age, to be constantly available, and to seek reassurance in the form of ‘likes’ on posts. Online abuse and harassment are also far too common.”

People with mental health issues can often feel isolated and finding specialist support can be a struggle. Early intervention is the key to success so that help can be offered when issues first emerge. In fact, the recent UK government green paper on adolescent mental health focuses on early intervention, suggesting schools should play a more central role.

“I feel like community pharmacies could do more to help with young people’s mental health issues too,” says Govind. “We need to start being more aware of what we can do to help. We are open longer hours than GP surgeries and are more available to talk to young people and help them realise they are not alone.”

For training, information about mental health conditions as well as tips for how to start a difficult conversation with a young person, community pharmacists can visit the YoungMinds website. If any adult is worried about a child or young person and wants specific advice and support, they can call the YoungMinds helpline on 08080 802 5544.

Spot check

Measles is a miserable disease that can have serious consequences, so the fact that the WHO Regional office for Europe revealed a four-fold increase in the disease last year, compared to the previous year, is of grave concern. 

“Every new person affected by measles in Europe reminds us that unvaccinated children and adults, regardless of where they live, remain at risk of catching the disease and spreading it to others who may not be able to get vaccinated,” says Dr Zsuzsanna Jakab, WHO regional director for Europe. “Over 20,000 cases of measles, and 35 lives lost in 2017 alone, are a tragedy we simply cannot accept.”

This large surge in outbreaks could be down to a decline in overall routine immunisation coverage, interruptions in vaccine supply or underperforming disease surveillance systems, reports the WHO.

Raising public awareness can help prevent new outbreaks taking place. This is something that community pharmacists can help with by communicating the benefits of immunisation and advising on disease control.

“Measles is a highly infectious disease so we would always advise customers to call the GP before visiting to minimise the spread of infection to other patients,” says Govind. “We can recommend products such as paracetamol to relieve symptoms and tips on how to make life more comfortable while they’re ill.”

Chicken pox is a common childhood disease that most children are likely to have caught by the age of 10. Although in most cases the disease is mild, serious complications can develop in some children.

Community pharmacists can help parents and children by warning them of the risk to other people they may have been in contact with. with. Those who are particularly vulnerable include pregnant women, new born babies, smokers who are not immune to chicken pox and people who do not have a fully-working immune system.

“Most parents tends to come in for treatment, so we advise them to avoid ibuprofen because of the risk of infections such as septicaemia,” says Govind. “We suggest customers to use calamine lotion from the fridge to cool and sooth spots and antihistamines to help with the itching.”

Dealing with sick children can be a worrying time for care givers, so being able to speak to a pharmacist for reassurance and advice can offer great peace of mind in a time of need.