Minor Ailment Schemes Research Articles

Minor ailment scheme extension could save NHS up to £640m annually, says PSNC

Supplying treatments for minor illness through community pharmacies in England could save the NHS up to £640m per year, the Pharmaceutical Services Negotiating Committee (PSNC) has said. In written evidence submitted to the Health and Social Care Select Committee as part of its inquiry into the ‘Future of General Practice’, which began in November 2021, […]

Community pharmacy staff oral health training, training needs and professional self-efficacy related to managing children's dental problems.

Few studies have explored the oral health training needs and professional self-efficacy (PSE) in both pharmacy support staff and pharmacists related to managing children's dental problems. This study assessed community pharmacy staff perceptions of their (i) training experiences and interests; (ii) PSE; and (iii) whether this was influenced by the pharmacy being part of a minor ailment scheme (MAS), where staff could directly offer advice and issue prescription medications without patients seeing a doctor. All of the 1851 community pharmacies across London, UK, were invited to participate in an online questionnaire. Staff rated their prior training, perceived need for further training and confidence in giving parents advice related to three dental problems in children (dental pain, mouth ulcers and dental trauma). Information was collected about staff roles and whether the pharmacy was a MAS. From 752 community pharmacies, 846 community pharmacy staff participated. Positive experiences of training were variable but interest in further training for all three dental problems was high. Pharmacy support staff had significantly lower PSE scores than pharmacy professionals (P=0.009). A significant interaction showed that pharmacy staff who had poorly rated prior training on advising parents about managing their child's dental pain and who did not work in a MAS had lower PSE scores than staff who had highly rated training and who worked in a MAS (P=0.02). Minor ailment scheme pharmacies may be an optimal environment for frontline pharmacy support staff to develop higher PSE when combined with good quality oral health training.

Community pharmacists' perceptions, attitudes and barriers towards pharmacist-led minor ailment services in Malaysia.

Background Community pharmacists are increasingly recognized to have an important role in providing a convenient and accessible alternative support for patients with minor ailments. In view of the abilities of community pharmacists in managing minor ailments, some countries have started the pharmacy-based minor ailment schemes that offers public access to treatment and advice of minor ailments from their local pharmacist. Nevertheless, there is limited study in Malaysia that explore the current practice of community pharmacists in managing minor ailment. Objective This study aims to evaluate community pharmacists' perceptions, attitudes and barriers of pharmacist-led minor ailment services. Setting Community pharmacists inMalaysia. Methods A cross-sectional survey among community pharmacists practicing in Malaysia was conducted between December 2017 until March 2018. The self-administered survey was distributed online via email, Facebook and WhatsApp's group. Main outcome measure Community pharmacists' perceptions, attitude and barriers towards minor-ailment service in community pharmacy settings. Results A total of 305 community pharmacists had completed the survey. The majority of community pharmacists in Malaysia had positive perceptions and attitudes towards pharmacist-led minor ailment services. The most common perceived barriers were lack of patient's medical information, absence of dispensing separation and lack of support from other healthcare professionals. Ethnicity, position and years of working experience were found to have significant associations with community pharmacists' score of attitudes and barriers related to minor ailment treatment in community pharmacy settings. Conclusion Community pharmacists in Malaysia have positive perceptions and attitudes over benefits of minor ailment services to public, however the barriers towards the service must be overcome to ensure service is sustainable for public's benefits.

Evaluation of a Collaborative Protocolized Approach by Community Pharmacists and General Medical Practitioners for an Australian Minor Ailments Scheme: Protocol for a Cluster Randomized Controlled Trial.

BackgroundInternationally, governments have been investing in supporting pharmacists to take on an expanded role to support self-care for health system efficiency. There is consistent evidence that minor ailment schemes (MASs) promote efficiencies within the health care system. The cost savings and health outcomes demonstrated in the United Kingdom and Canada open up new opportunities for pharmacists to effect sustainable changes through MAS delivery in Australia.ObjectiveThis trial aims to evaluate the clinical, economic, and humanistic impact of an Australian Minor Ailments Service (AMAS) compared with usual pharmacy care in a cluster randomized controlled trial (cRCT) in Western Sydney, Australia.MethodsThe cRCT design has an intervention group and a control group, comparing individuals receiving a structured intervention (AMAS) with those receiving usual care for specific health ailments. Participants will be community pharmacies, general practices, and patients located in Western Sydney Primary Health Network (WSPHN) region. A total of 30 community pharmacies will be randomly assigned to either intervention or control group. Each will recruit 24 patients, aged 18 years or older, presenting to the pharmacy in person with a symptom-based or product-based request for one of the following ailments: reflux, cough, common cold, headache (tension or migraine), primary dysmenorrhea, or low back pain. Intervention pharmacists will deliver protocolized care to patients using clinical treatment pathways with agreed referral points and collaborative systems boosting clinician-pharmacist communication. Patients recruited in control pharmacies will receive usual care. The coprimary outcomes are rates of appropriate recommendation of nonprescription medicines and rates of appropriate medical referral. Secondary outcomes include self-reported symptom resolution, health services resource utilization, and EuroQoL Visual Analogue Scale. Differences in primary outcomes between groups will be analyzed at the individual patient level accounting for correlation within clusters with generalized estimating equations. The economic impact of the model will be evaluated by cost-utility and cost-effectiveness analysis compared with usual care.ResultsThe study began in July 2018. Thirty community pharmacies were recruited. Pharmacists from the 15 intervention pharmacies were trained. A total of 27 general practices consented. Pharmacy patient recruitment began in August 2018 and was completed on March 31, 2019.ConclusionsThis study may demonstrate the efficacy of a protocolized intervention to manage minor ailments in the community and will assess the clinical, economic, and humanistic impact of this intervention in Australian pharmacy practice. Pharmacists supporting patient self-care and appropriate self-medication may contribute to greater efficiency of health care resources and integration of self-care in the health system. The proposed model and developed educational content may form the basis of a national MAS service in Australia, using a robust framework for management and referral for common ailments.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618000286246; http://www.anzctr.org.au/ACTRN12618000286246.aspxInternational Registered Report Identifier (IRRID)DERR1-10.2196/13973

Community pharmacies offering minor ailment schemes fall by a third in 2018/2019

Community pharmacies offering minor ailment schemes fall by a third in 2018/2019

Pharmacy minor ailment scheme discontinued after NHS England OTC guidance

Pharmacy minor ailment scheme discontinued after NHS England OTC guidance

No plans to commission national minor ailment scheme in England, says pharmacy minister

No plans to commission national minor ailment scheme in England, says pharmacy minister

Eat or treat? How cuts to minor ailment schemes could hit patients hard

Eat or treat? How cuts to minor ailment schemes could hit patients hard

Quality improvement of community pharmacy services: a prioritisation exercise.

ObjectivesEffective strategies are needed to translate knowledge (evidence) into practice to improve the quality of community pharmacy services. We report the first step of a novel knowledge translation process which involved the systematic identification and prioritisation of community pharmacy services in Scotland which were perceived to require improvement and/or guideline development.MethodsThis process involved three stages and a stakeholder group comprising community pharmacists, policy makers, lay and pharmacy organisation representatives. A modified nominal group technique (NGT) was used for topic generation (August 2013) followed by an electronic Delphi survey (eDelphi), October–December 2013) and topic rationalisation (December 2013) based on feasibility, acceptability, and potential impact for practice improvement.Key findingsIn total, 63 items were identified during the modified NGT which were categorised into 20 topics to form the starting point of the eDelphi. In total, 74 individuals (mostly community pharmacists) indicated an interest in the eDelphi, which achieved response rates of 63.5%, 67.6%, and 70.3%, respectively in Rounds 1, 2, and 3. Consensus was achieved with six topics: promoting the appropriate sale and supply of over‐the‐counter medicines; patient counselling for prescribed medication; pharmaceutical care to promote medication adherence; promotion and delivery of a Minor Ailment Scheme; pharmaceutical care of vulnerable patients; and effective use of community pharmacy workforce. Of these, the priority topic selected for the next stage of the programme was promoting the appropriate sale and supply of over‐the‐counter medicines.ConclusionsThis study adopted a systematic, inclusive, and rapid approach to identify priorities for community pharmacy practice improvement in Scotland.

Economic Evaluation of Minor Ailment Schemes (MAS) in the UK

Objective Self-care is considered as a possibility to empower patients and to achieve possibly efficiency gains. However, there is a lack of evidence whether, or not, self-care initiatives can contribute to achieve efficiency gains. The aim of this research is to perform an economic evaluation of the Minor Ailment Schemes (MAS), a self-care initiative in the UK. Methods To assess potential savings of the MAS through an economic evaluation we surveyed medical and non-medical costs and benefits under three different scenarios (GP consultation, self-care with medication, self-care with home remedies). We applied this framework to evaluate the effects of the MAS with regard to the treatment of five common minor ailments (Athlete’s foot, cold, cough, heartburn and lower urinary tract infection) from four different perspectives (patient, payer, provider and society). Results The evaluation shows that patients would be better off shifting to utilisation of MAS, particularly patients who pay prescription charges. From the pharmacists’ perspective MAS could lead to higher costs due to continuous training and a more time needed for consultation. The results from the physicians’ perspective were mixed depending on the payment mechanism and on the alternatives physicians used out of the freed resources. From a societal perspective, a positive net welfare impact will only be achieved if more than a fourth of the patients with minor ailments use the MAS. Conclusion MAS may have the potential to achieve positive net societal benefits and can have a role to play in the optimisation of health care systems. However, it needs to be considered that MAS may lead to negative net benefits for some stakeholders. Furthermore, MAS are embedded in the UK health care setting and its effects are determined by internal factors (e. g. “self-care culture”) and external factors (e. g. pharmaceutical policies). It is thus recommended carrying out a thorough analysis of the health care setting to which the self-care initiative is planned to be transferred.

MP group wants pharmacist prescribers and minor ailment scheme in England

MP group wants pharmacist prescribers and minor ailment scheme in England

Bigger role for pharmacists as Scotland pilots extension of minor ailment scheme

Bigger role for pharmacists as Scotland pilots extension of minor ailment scheme

Evaluation of the effectiveness of an Internet-based continuing education program on pharmacy-based minor ailment management: a randomized controlled clinical trial

ABSTRACT The aim of this work was to evaluate the effectiveness of an internet-based continuing education (CE) program on pharmacy-based minor ailment schemes (PMASs). A controlled randomized clinical trial was conducted in community pharmacies in Brazil. Community pharmacists (CPs) were enrolled in two groups: intervention (n = 61) and control (n = 60). CPs who were enrolled to the intervention group participated in an Internet-based CE program. CPs in the control group received no educational intervention. We evaluated participant perception, learning outcomes, and practice performance. Learner satisfaction with the CE program was high for every point evaluated (mean ± standard deviation = 4.2 ± 0.4). Posttest learner outcome scores and practice performance in the intervention group after the conclusion of the CE program significantly improved compared with pretest scores (p < 0.001) and were significantly better compared with the control group (p < 0.001). The present Internet-based CE program is a viable educational strategy for improving participant perception, learning outcomes, and practice performance in PMASs.

The evolution of pharmaceutical care for drug misusers.

In the last 20 years, pharmaceutical care has evolved as a modus operandi for community pharmacy. This article tracks the development of pharmaceutical care for drug misusers since 1995 and considers the implications for pharmacy engagement with the wider care team. To survey current community pharmacy service provision for drug misusers, past training and future training needs and compare with data from previous years (1995, 2000 and 2006). A cross-sectional postal questionnaire of pharmacy managers in Scotland (n = 1246), and telephone interviews with non-respondents. Results were compared with previous surveys. The response rate was 70% (873) including 13.2% (164) by telephone. More pharmacies dispensed methadone in 2014 (88.5%) than previously, a significant increase across all time points (1995, 2000 and 2006) (P < 0.001). Most pharmacies (88.1%) had some drug misusers registered for the minor ailment scheme. In 2014, 43.4% of pharmacists always reported a drug misuser's non-attendance for opiate replacement treatment (ORT) to the prescriber (36.6% in 2006). If patient intoxication was suspected, medication was always withheld by 47.9% (27.5% in 2006). Pharmacists undertaking training in drug misuse and blood-borne diseases increased significantly since 1995, to 78.6% and 48.7%, respectively, in 2014 (P < 0.001). The preferred topic for future training was communication/engagement with other services. Pharmaceutical care for drug misusers has evolved from ORT supply to a more clinical approach. Pharmacists actively monitored ORT patients, managed their minor ailments and increasingly engaged with the wider care team.

A cost/benefit analysis of self-care initiatives in the European Union: who gains, who loses?

European health systems have increasingly come under pressure to implement cost-containment measures while simultaneously maintaining or even enhancing high-quality health care. In the field of medication of minor ailments, a promising approach to achieve this is initiatives promoting patient involvement (i.e. self-care). Therefore, the aim of the study was to analyse potential costs and benefits related to self-care oriented health systems in the European Union. A cost/benefit analysis (CBA) was conducted covering modified access to prescription medicines, extended range of authorized prescribers and internet/telephone information portals. Costs and benefits were calculated for selected initiatives: minor ailment schemes (MAS), non-medical prescribing (NMP) and NHS Choices in England. The CBA covered four perspectives: patient, provider (physician, pharmacist), system and society. A standard costing approach was used to facilitate transferability of results. In all studied initiatives, patients benefit from time savings due to avoided physician visits, compensating for occasionally higher out-of-pocket payments for medicines. Physicians are confronted with a negative benefit due to loss of income, which corresponds to a positive effect at the system level. If the initiatives' costs do not provide for additional remuneration for pharmacists, increased time for consultations will lead to a negative benefit for pharmacists. In order to gain a positive societal net benefit, participation rates (in terms of patients with minor ailments refraining from a GP consultation due to an initiative) of 27.5% for MAS and 4.4% for NHS Choices are required. For NMP costs at providers' (i.e. pharmacists') levels are too high for a positive societal net benefit. Self-care initiatives based on modified access schemes and information portals may lead to a societal benefit, whereas the mere extension of prescribing authority does not do so. As actual cost components of the initiatives (e.g. provider remuneration) and pharmaceutical reimbursement policies (e.g. prescriptions fees) are likely to affect savings and costs, these have to be considered when implementing a policy.

National minor ailment scheme could help save NHS £1bn

National minor ailment scheme could help save NHS £1bn

Are pharmacy-based minor ailment schemes a substitute for other service providers? A systematic review.

Pharmacy-based minor ailment schemes (PMASs) have been introduced throughout the UK to reduce the burden of minor ailments on high-cost settings, including general practice and emergency departments. This study aimed to explore the effect of PMASs on patient health- and cost-related outcomes; and their impact on general practices. Community pharmacy-based systematic review. Standard systematic review methods were used, including searches of electronic databases, and grey literature from 2001 to 2011, imposing no restrictions on language or study design. Reporting was conducted in the form recommended in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist. Thirty-one evaluations were included from 3308 titles identified. Reconsultation rates in general practice, following an index consultation with a PMAS, ranged from 2.4% to 23.4%. The proportion of patients reporting complete resolution of symptoms after an index PMAS consultation ranged from 68% to 94%. No study included a full economic evaluation. The mean cost per PMAS consultation ranged from £1.44 to £15.90. The total number of consultations and prescribing for minor ailments at general practices often declined following the introduction of PMAS. Low reconsultation and high symptom-resolution rates suggest that minor ailments are being dealt with appropriately by PMASs. PMAS consultations are less expensive than consultations with GPs. The extent to which these schemes shift demand for management of minor ailments away from high-cost settings has not been fully determined. This evidence suggests that PMASs provide a suitable alternative to general practice consultations. Evidence from economic evaluations is needed to inform the future delivery of PMASs.

Two million therapies given under Scottish minor ailment scheme

Two million therapies given under Scottish minor ailment scheme

Cost analysis of a community pharmacy 'minor ailment scheme' across three primary care trusts in the North East of England

A large proportion of primary care medical consultations relate to minor ailments, placing a substantial burden on the UK National Health Service (NHS). In response, minor ailment schemes (MAS) have been introduced in several community pharmacies. Patients using MAS across three neighbouring primary care trusts were asked what action they would have taken if the MAS had not been in place. The net cost impact of the MAS was calculated using standard health-care reference costs. The observation period was one calendar month with annualized cost data. During the observation period 396 patients used the MAS of whom 230 (58.1%) stated they would have made an appointment with their general practitioner (GP) if the MAS was not in place. A further 155 (39.1%) would have bought a medicine from the pharmacy. Other responses included attending the accident and emergency department at hospital (n= 2), consulting a health visitor (n= 1), or doing nothing (n= 8). The MAS is estimated to reduce local health-care costs by £6739 per month. MAS release NHS resources (especially in relation to GP consultations) by preventing (or minimizing) patient use of alternative and more costly branches of the NHS.