Minor Ailment Service Research Articles

Advancing Pharmaceutical Care in Community Pharmacies in Poland: A Blueprint for Enhanced Patient Care Quality.

Background: This article reviews the current state of pharmaceutical care in community pharmacies in Poland and proposes a collaborative framework for its advancement. While pharmaceutical care has evolved significantly worldwide, with Europe leading the way, Poland has lagged in its development. Although Polish pharmacists are well-qualified and community pharmacies are numerous, pharmaceutical care remains underdeveloped. Methods: We conducted a literature review and analyzed case studies from European countries with advanced pharmaceutical services. Based on these findings, we collaborated with policy makers, commissioners, and academics to develop a framework for enhancing pharmaceutical care in Poland. The plan emphasizes integrating seven key services into Polish community pharmacies. Results: Our proposed framework outlines seven essential pharmaceutical services: medicine use reviews, new medicine services, minor ailment services, repeat prescription services, integrated prevention programs, cardiovascular disease prevention programs, and vaccination programs. Evidence from other European countries suggests that implementing these services could significantly improve health outcomes and patient quality of life. This is particularly important in light of Poland's ageing population, the rising prevalence of chronic diseases, and the healthcare system's increasing burden due to polypharmacy. Conclusions: The proposed framework presents a practical and collaborative approach to advancing pharmaceutical care in Poland. By adopting these key services, community pharmacies could play a more integral role in improving patient care quality and alleviating pressure on the broader healthcare system.

Assessing Public Awareness, Utilization and Satisfaction with Community Pharmacy Services.

The Saudi Community pharmacy sector has been changing towards patient-centred care rather than depending solely on dispensing medications. Accordingly, pharmacies can now provide many services that they previously could not offer. The aims of this study were to identify all pharmacy services provided in a community setting and to assess public awareness and utilization of and satisfaction with these services. This was a cross-sectional study in which the authors first purposively visited community pharmacies to identify the services offered. Pharmacists were asked about pharmacy services currently provided to community. Fieldnotes were used to document pharmacists' responses. After identifying pharmacy services, a questionnaire was desgined and reviewed by experts in the field, piloted and approved by the Ethics Committee at King Faisal University, then disseminated via Google Forms. The satisfaction level with pharmacy services was assessed using a five-point Likert scale. Data were collected from 24 January 2023 to 2 March 2023. Eighteen community pharmacies offering 17 different services were visited across Alahsa Governorate. The number of participants who completed the questionnaire was 350. Of those (232 [66.3%]) were female, and the majority of the sample (80.5%) were younger than 40 years old. The majority of the participants were unaware of pharmacy services. Out of 17 services, six received a score of 50% or higher regarding participant awareness. The most utilized services were the medication dispensing service "Wasfaty" (250 [71.4%]), medication counselling provided by pharmacists (232 [66.3%]) and minor ailment service (231 [66%]). The overall satisfaction score for pharmacy services was 87.2%. The majority of the participants were unaware of the full range of available pharmacy services. There is a potential for community pharmacists to fill the capacity gap in the healthcare system since, overall, the participants rated the pharmacies' clinical services as satisfactory. Commissioners of pharmacy services may consider extending the scope of community pharmacies to include services that best utilize the expertise of clinical pharmacists.

Using thematic analysis to evaluate views of community pharmacy staff about the Enablers and Barriers of Antibiotic Amnesty campaigns

Abstract Introduction Antibiotic-resistant infections are the biggest threat to modern medicine. In 2019 there were 1.27 million deaths globally as a result of antibiotic resistance. Without a solution, estimates predict that by 2050 that number will be closer to 10 million people every year who are dying from previously treatable bacterial infections1. The end of the antibiotic era is a rising concern, as antimicrobial resistance continues to be recognised as a global health threat2. Promoting appropriate use and disposal of antibiotics is a key aspect of antibiotic amnesty campaigns, which work towards the bigger picture of reducing antimicrobial resistance (AMR)3. Studies that fill in the gaps in knowledge regarding the challenges and solutions to antibiotic amnesties are lacking. Aim To investigate the main enablers and barriers of antibiotic amnesty campaigns in community pharmacies in Huddersfield, Bradford, Leeds and Sheffield and to identify the most commonly returned antibiotics. Methods This study required and received ethics approval from the University of Huddersfield. A semi-structured interview guide was developed and used to interview consenting community pharmacy staff located in Huddersfield, Bradford, Leeds and Sheffield. Data was collected over a designated 5-week period in January and February 2023 by audio recorded interviews either over Microsoft Teams or face-to-face. Data was groups into themes. All recordings were deleted once transcribed. Results There were 20 interviews conducted, averaging 20 minutes in duration. Participants included 10 pharmacists, 5 pharmacy technicians and 5 medicine counter staff which were evenly divided between age groups 18-39 (n=10) and 40-59 (n=10). The main themes extracted at analysis included; factors enabling campaigns, antibiotic challenges relating to unnecessary use, education enabling amnesty campaigns, and raising awareness to maximise return of unwanted antibiotics. The sub-themes from all three staff groups which suggested enablers for antibiotic amnesty campaigns were, counselling patients, promotional resources and personal approach. The barriers were lack of educating staff, antibiotic misuse by patients, fear of re-infection (saving spare), minor ailments service, inappropriate prescribing and lack of patient education. The most frequently returned antibiotics were penicillins, especially amoxicillin. Discussion/Conclusion The main enablers of antibiotic amnesties are effective counselling and successful use of promotional resources. The main barriers were lack of patient education and lack of staff education. These barriers can be tackled with provision of sufficient education, training and knowledge for patients. Staff could increase the chances of success with antibiotic amnesty campaigns in the future by addressing these issues. Amoxicillin was the most returned antibiotic. It is used to treat many types of bacterial infections, especially respiratory. Shorter courses, back-up prescriptions or alternative treatment options should be considered to reduce leftovers. Study limitations include accounting for ethnicity. Future studies should include more medium and large chain pharmacies over a wider geographical area.

Development of self-care in Spanish community pharmacies

Spain is a European country with over 47.5 million inhabitants and a public National Health System model (i.e., SNS or “Sistema Nacional de Salud”) that provides universal coverage to residents and non-residents. The system is funded primarily by general taxes, and it is managed by the 17 regions that have responsibility for the provision and management of healthcare services in their respective territories. The health system recognizes self-care as an important element where individuals have an important role to play in maintaining their own health and preventing illness. In addition, there are non-governmental organizations that promote self-care and provide resources and support to individuals and health professionals.Over 55 thousand pharmacists work in 22,198 community pharmacies distributed throughout the Spanish territory. Pharmacies are the only setting that provide non-prescription medications, which is one of the most used tools for self-care. In addition, they provide a range of Primary Care services to improve patient outcomes and the efficiency of the SNS. This paper includes a description and a classification of the community pharmacy services following the seven pillars of self-care established by the International Self-Care Foundation:-Related to pillars 1 to 4 and 6, Spanish community pharmacists provide health promotion, health education, health information and nutritional assessment.-In relation to pillar 5, the services offered are HIV and syphilis screening, colorectal and cervix cancer screening, SARS-CoV-2 screening test and communication, diabetes, high blood pressure and hypercholesterolemia screening. Regarding the programs for avoiding/stopping drug use: methadone supply, syringe exchange and smoking cessation. Another important service is immunization. Spanish community pharmacists are not legally allowed to vaccinate; however, they contribute through education, or vaccines supply, among others.-For the pillar 7, community pharmacists provide services such as a minor ailment service, an adherence service or a network to actively monitor medication safety (sentinel pharmacies).-Many of the pharmacy services related to self-care have been defined and classified at a national level; however, not all community pharmacies provide them while only some services are funded by the regional health systems.

Pharmacists and Pharmacy Technicians' Perceptions of Scopes of Practice Employing Agency Theory in the Management of Minor Ailments in Central Indonesian Community Pharmacies: A Qualitative Study.

Community pharmacy staff assist in the management of minor ailments. Agency Theory underpins relationships between health professionals and patients. This study explores pharmacists' and pharmacy technicians' perceived scopes of practice of minor ailment services in community pharmacies. Twelve one-on-one semi-structured interviews used an open-ended interview guide for each cohort of community pharmacists and pharmacy technicians, between June and July 2021. Purposive sampling selected a diversity of pharmacists and pharmacy technicians. Interviews were transcribed verbatim, thematically analysed assisted by NVivo version 20. Agency Theory aided the interpretation. Three main themes emerged: (1) inconsistencies in practice, (2) the lack of understanding of the scopes of practice of pharmacists and pharmacy technicians, and (3) provision of prescription-only medicines for some minor ailments or to fulfil patient requests. Several sub-themes included pharmacy staff involvement, education and training, provision of prescription-only medicines, and weak regulatory enforcement. Agency Theory indicated pharmacy patients (principals) delegated authority to pharmacists and pharmacy technicians (agents), which was confused by partial pharmacist absence. The lack of defined scopes of practice for pharmacists and pharmacy technicians disrupted established professional relationships. The scopes of practice and roles of the pharmacist and pharmacy technicians should be clearly defined, assisted by practice guidelines.

Identification of high-risk patients for referral through machine learning assisting the decision making to manage minor ailments in community pharmacies.

Background: Data analysis techniques such as machine learning have been used for assisting in triage and the diagnosis of health problems. Nevertheless, it has not been used yet to assist community pharmacists with services such as the Minor Ailment Services These services have been implemented to reduce the burden of primary care consultations in general medical practitioners (GPs) and to allow a better utilization of community pharmacists' skills. However, there is a need to refer high-risk patients to GPs. Aim: To develop a predictive model for high-risk patients that need referral assisting community pharmacists' triage through a minor ailment service. Method: An ongoing pragmatic type 3 effectiveness-implementation hybrid study was undertaken at a national level in Spanish community pharmacies since October 2020. Pharmacists recruited patients presenting with minor ailments and followed them 10days after the consultation. The main outcome measured was appropriate medical referral (in accordance with previously co-designed protocols). Nine machine learning models were tested (three statistical, three black box and three tree models) to assist pharmacists in the detection of high-risk individuals in need of referral. Results: Over 14'000 patients were included in the study. Most patients were female (68.1%). With no previous treatment for the specific minor ailment (68.0%) presented. A percentage of patients had referral criteria (13.8%) however, not all of these patients were referred by the pharmacist to the GP (8.5%). The pharmacists were using their clinical expertise not to refer these patients. The primary prediction model was the radial support vector machine (RSVM) with an accuracy of 0.934 (CI95 = [0.926,0.942]), Cohen's kappa of 0.630, recall equal to 0.975 and an area under the curve of 0.897. Twenty variables (out of 61 evaluated) were included in the model. radial support vector machine could predict 95.2% of the true negatives and 74.8% of the true positives. When evaluating the performance for the 25 patient's profiles most frequent in the study, the model was considered appropriate for 56% of them. Conclusion: A RSVM model was obtained to assist in the differentiation of patients that can be managed in community pharmacy from those who are at risk and should be evaluated by GPs. This tool potentially increases patients' safety by increasing pharmacists' ability to differentiate minor ailments from other medical conditions.

The educational requirements to support community pharmacy staff to deliver minor ailment services - A modified Delphi study

The educational requirements to support community pharmacy staff to deliver minor ailment services - A modified Delphi study

Factors and strategies for the implementation of a minor ailment service: a case study

Minor ailment service (MAS) is a professional pharmacy service assisting patients to manage minor ailments. MAS involves a structured consultation process with protocols which delineate professional practice. INDICA+PRO is a project, started in 2017, which evaluates the impact and subsequently implementation of MAS in Spanish community pharmacies. This paper reports on the experience of implementing the service in a single pharmacy.Implementation factors (barriers and facilitators) were detected and a series of strategies were developed and used as part of the implementation program of MAS through a practice program, INDICA+PRO. The implementation strategies, such as highlighting the advantages of MAS for the pharmacy, incentives for the provision of the service and/or the distribution of tasks within the team were used to overcome barriers. Facilitators included the availability of a consultation room in the pharmacy, good relationships with nearby health centers and the provision of other professional services in the pharmacy.The advantages obtained from MAS, following the inclusion in the software (SEFAC eXPERT®) of the agreed protocols and clinical information, were improved patient follow-up, increased communication within the team and with patients, the pharmacy having a clinical history of the minor ailments and the ability of being able to prepare standardized reports.

Use of pharmacy common minor ailments service in Wales increased by almost 50% during winter 2022/2023

Use of pharmacy common minor ailments service in Wales increased by almost 50% during winter 2022/2023

Public’s Preferences for Community Pharmacy Attributes and Their Perceptions Towards Pharmacist-led Minor Ailment Services in Malaysia

Introduction: The prospect of public accessing community pharmacies for minor ailment advice or treatment highly depends on the pharmacy attributes and their staff. This study aimed to investigate the extent to which community pharmacies are used as a source of minor illness management and the public’s relative preferences for pharmacy features. Methods: A cross-sectional survey among the public in Malaysia was carried out between August and December 2020. The validated self-administered questionnaires were distributed at several pharmacies and shared via email, Whatsapp group, and Facebook. Results: A total of 141 from 153 public respondents completed the survey. From the descriptive and inferential analysis, it was found that about a third of the public goes to a pharmacy for advice or treatment for minor illnesses. The vast majority of respondents had positive perceptions that community pharmacists are knowledgeable and qualified to offer advice or treatment for minor diseases. A significant positive relationship was observed between pharmacy characteristics’ scores and pharmacy staff and pharmacy services’ scores (p<0.001). The increase in pharmacy staff score significantly increased the pharmacy services’ score (p<0.001). Conclusion: The implications of the public acknowledging specific attributes were crucial in further supporting community pharmacists’ services, especially in the private practice setting.

Examining equity in a void of evidence - Pharmacist minor ailments services and the role of systematic reviews

Pharmacist minor ailment services (PMAS) are formalised services which remunerate pharmacists for delivering care and providing medicines used to treat minor ailments such as hayfever, musculoskeletal pain, head lice and constipation. PMAS have been postulated to improve medicines access equity yet there is little evidence to suggest that equitable health outcomes from PMAS have been achieved in those countries where these services have been initiated. Systematic reviews are regarded as the gold standard in assessing evidence of outcome effectiveness, including equity of outcomes. Our research team developed a systematic search strategy and review protocol to examine ethnic variation in PMAS outcomes. No results were returned, even with the inclusion of grey literature, and therefore the impact of PMAS on ethnic equity could not be examined. This commentary discusses the potential for PMAS to achieve medicines access equity and the role of empty reviews in identifying gaps in the literature and advocating for equity.

Predictors of enablers and barriers to community pharmacists’ management of minor ailments in a developing setting: A theory-driven assessment

BackgroundThe clinical and financial burdens associated with minor ailments are well documented, but published evidence suggests that minor ailment services led by community pharmacists have a remarkable positive impact, mainly in developed settings. There is a paucity of evidence on community pharmacists’ self-perceived enablers and barriers to the effective management of minor ailments. ObjectivesThe objective of the study was to identify community pharmacists’ self-perceived enablers and barriers to the effective management of minor ailments as well as their significant predictors. MethodsA Kurt Lewin’s theory-driven cross-sectional survey of 305 community pharmacists was conducted in Qatar using a pretested 25-item structured questionnaire developed with an adapted conceptual framework focused on 4 key areas: education, regulation, practice, and research. Bivariate logistic regression was used to identify significant predictors of community pharmacists’ self-perceived enablers and barriers. ResultsThe response rate was 92.5% (282/305). Most of the respondents (68.1%) were males, who were 31-40 years of age (55.3%) and worked for pharmacy chains (77.3%). Community pharmacists identified a higher proportion of enablers (positive force) (82.4%) relative to only 3 barriers (negative force) (17.6%). The barriers identified included insufficient private or semiprivate space for patient counseling, the paucity of invitations to participate in practice-based research, and lack of feedback regarding the results and recommendations of previous research in which they were participants. The significant predictors of self-perceived enablers and barriers were female gender (odds ratio [OR], 2.21; 95% CI, 1.25-3.91; P = 0.007) and age group of ≤40 years (OR, 4.74; 95% CI, 3.50-7.16; P = 0.006). ConclusionCommunity pharmacists’ perceptions of the factors that enhance their effective management of minor ailments were overwhelmingly positive, as 14 enablers were identified relative to only 3 barriers. Female and young community pharmacists were significantly more likely to perceive enablers than barriers. The insights provided are potentially useful in developing pharmacy-based schemes to improve the effective management of minor ailments.

Changes to community pharmacy practice during the COVID-19 pandemic: a cross-country documentary analysis

IntroductionCommunity pharmacy has played a frontline role during the COVID-19 pandemic (1,2). Governments and professional organisations in the United Kingdom and Republic of Ireland (RoI) have acknowledged the need to support and maximise community pharmacy to maintain delivery of patient care. However, the pandemic’s impact on day-to-day changes to community pharmacy practice has not been comprehensively examined across the island of Ireland.AimTo identify changes as communicated by policy and professional bodies to community pharmacy practice across the island of Ireland in preparation for and/or response to the COVID-19 pandemic, and to compare identified changes in Northern Ireland (NI) and RoI.MethodsGovernment, health service, regulatory and professional organisation websites in both NI and RoI were searched using relevant search terms (e.g. pharmacist, COVID-19). Any document (e.g. official publications/reports, website pages, circulars) containing information relating to changes to community pharmacy-related infrastructure, funding/resourcing, legislation, guidelines or policies in preparation for, and/or response to, COVID-19, published between 1st January and 31st October 2020 was included. Guidelines on clinical use of medicines were excluded as this was considered a separate topic. Initial screening of each website was undertaken by one reviewer. Brief details of potentially relevant documents were collated in a spreadsheet. Following removal of duplicates, full-texts of identified documents were assessed for inclusion by two reviewers independently, with discrepancies resolved through discussion. A content analysis was undertaken.ResultsIn total, 253 documents were identified. Following removal of duplicates and screening, 98 documents were included in the analysis. Most documents were published in the first three months of the pandemic (March-May 2020). A key theme related to medication prescribing and supply, with changes implemented to ensure continued access to medicines. In both NI and RoI, significant changes were made to emergency supply arrangements (e.g. increase in allowable duration of supply at the request of patients). In RoI, legislative changes were made to recognise Healthmail as the national electronic prescription transfer system and to temporarily extend prescription validity. In NI, many community pharmacy services (e.g. Minor Ailments Service, Medicines Use Review) were ‘stood down’ during initial months of the pandemic. Much of the communication in NI and RoI related to operational changes to ensure business continuity. In both jurisdictions a temporary register of pharmacists was introduced to allow previously registered pharmacists to contribute to the health service response. Additionally, in NI, General Dental Practitioners were redeployed to assist with community pharmacy response. Other areas of focus across both jurisdictions included infection control within a workplace setting, dealing with situations where staff were affected by COVID-19, and the use of personal protective equipment during pharmacy service provision.ConclusionThis study examined changes in community pharmacy practice across two jurisdictions during the COVID-19 pandemic. Whilst our searches were limited to publicly accessible documents only, the overlap in identified changes reflects the similarities in challenges faced by community pharmacists in adapting and responding to COVID-19. The cross-country comparison may help pharmacists and policy-makers to identify optimal approaches for responding to any future public health crises.Reference(1) Cadogan CA, Hughes CM. On the frontline against COVID-19: community pharmacists’ contribution during a public health crisis. Res Soc Adm Pharm. 2021; 17(1): 2032-2035.(2) Maidment I, Young E, MacPhee M, Booth A, Zaman H, Breen J, Hilton A, Kelly T, Wong G. Rapid realist review of the role of community pharmacy in the public health response to COVID-19. BMJ Open. 2021; 11(6): e0500043

Intervention model for detection, prevention and control of COVID-19 in community pharmacy

The announcement by the WHO of the characterization of the new Coronavirus 2019 disease (COVID-19) as a pandemic, entails an adaptation by the community pharmacy in carrying out its care activity in general, with particular emphasis on ”Minor Ailments Service” in particular. The measures taken by the different health administrations in which patient telephone care by primary care offices is prioritized have left more consultations on symptoms in the community pharmacist health-related problems as pharmacies are the closest health facilities to the patient. The similarity between the symptomatology caused by the new Coronavirus with that of some Enteroviruses that cause mild respiratory and gastrointestinal tables (dry cough, fever, sore throat, vomiting, diarrhoea, etc.) makes community pharmacies highly capable places for contagion detection and prevention. A model of protocolized intervention is needed to facilitate the pharmacist’s work in discriminating during the indication between minor symptoms and symptoms of referral for possible cases of COVID-19 so that in conjunction with the rest of the staff we help control the disease and make better use of primary care consultations.

Pharmacies prevented from signing up for minor ailments service over AMR concerns

Community pharmacies across the Midlands are being prevented from signing up to provide a locally-commissioned minor ailments service because of an NHS England review of how antibiotics are supplied. A letter sent to pharmacies in January 2022, seen by The Pharmaceutical Journal, reveals that the service has been “paused” after NHS England commissioned a review […]

Government response suggests 'Pharmacy First' policy in England is under development

The UK government’s refusal to disclose information relating to the launch of a national minor ailments service for community pharmacy has inferred that a policy on the service is being developed. A freedom of information (FOI) request submitted by The Pharmaceutical Journal asked the Department of Health and Social Care (DHSC) to disclose discussions it […]

Extra £2.5m for pharmacies in Wales to improve access to minor ailments service

Community pharmacies in Wales will be given an extra £2.5m from the Welsh government to improve patient access to common ailment advice and treatment. The £2.5m pot equates to up to £3,500 for each community pharmacy in Wales that provides the ‘Choose Pharmacy’ common ailment service, which provides patients in Wales with free community pharmacy-based […]

Pharmacies could receive 275,000 extra minor ailments service referrals annually

Community pharmacies in England could receive 275,000 additional referrals each year from NHS 111 after more minor illness symptoms were included for referral to the ‘Community pharmacist consultation service’ (CPCS), the Pharmaceutical Services Negotiating Committee (PSNC) has said. In a statement on its website, published on 14 January 2022, the PSNC said a review of […]

Adaptation of practical classes of clinical subjects in the COVID-19 era

Pharmaceutical Care is a subject within the Pharmacy Degree that is taught using theoretical and practical classes. When COVID-19 appeared, Faculty of Pharmacy had to change its way of teaching and learning to online classes. Our aim is to assess the impact of COVID-19 situation on practical classes in Pharmaceutical Care. A prospective study was performed by undergraduate students from Pharmaceutical Care subject. Students attended to 2-day practical classes and were assessed through an evaluative workbook. Undergraduate students (n=390) obtained a score of 8.4±0.8 in practical classes, being higher in face-to-face sessions than online sessions, but not significant differences among both methodologies. The higher score was for the session of minor ailment services (9.3±1.3) and the lower for Personalized Medication Dosage (7.0±1.6) and similar in both scenarios. 59% of students obtained more than 8 score in the global punctuation, being higher in in-face-to-face practical classes. This study showed that learning in health care can be guided and evaluated through an online method. Adapt to new technologies, prevent vulnerable students from being left behind, as well as working on cross-cutting skills at a distance, are some of the challenges of higher education in times of COVID-19.

Community Pharmacists' Attitudes and Practice in the Management of Minor Ailments

This study aimed to know the attitudes and practice of pharmacists regarding the management of minor ailments in Iraqi community pharmacies. A cross-sectional study for 320 community pharmacists was conducted during February 2020 using a newly developed and validated questionnaire. Only 4.4% of pharmacists prefer not to deal with minor ailment cases. Minority (15.6%) of participated pharmacists refer more than half of minor ailment cases they face to the physician. Regarding the assessment of minor ailments using WWHAM technique, what are the symptoms are the most commonly asked questions by pharmacists. Only 49.1% mentioned that they ask all WWHAM questions. On the other hand, most pharmacists (90%) educate their patients about the dosing regimen. Meanwhile, less than 10% of pharmacists provide their patients with all possible information about their medications. All demographic factors had no effect on the pharmacists' usage of WWHAM technique and in pharmacist's role in patient counseling or education. In conclusion minor ailment services that provided by community pharmacists' in Iraq was poor at which most pharmacists don't use WWHAM technique appropriately and also fail to provide their patients with the required medication counseling and education.