Posted by: Audrey Thompson13 AUG 2014
Although the London 2012 pharmacy service operated a minor ailments service, this had never before been offered at a Commonwealth Games. In Scotland, the community pharmacy contract with the NHS has included a Minor Ailments Service since 2006.
The scheme was designed to enable non-athletes eligible for medical services in the village to obtain symptomatic treatment for a range of minor conditions. When appropriate, pharmacists operating the scheme could refer patients to the polyclinic doctors or other health care professionals, using a specific referral form. People presenting with reportable symptoms of infection, such as diarrhoea, vomiting or fever, were referred to the Polyclinic doctors or public health in the Village for further assessment. Team coaches or officials could self-refer to the scheme or be referred by the polyclinic triage nurses or other health care providers. In each case, the pharmacist undertakes a private, confidential consultation. There were a series of protocols to support decision making and all encounters were logged on the Games medical encounter system and an item dispensed from pharmacy if required.
The pharmacy team provided the minor ailments service to representatives of more than 40 different countries from Anguilla to Zambia via Niue and Norfolk Islands. Each country is given a three letter code to identify it. Scotland is SCO; England is ENG. Several of our pharmacists were highly amused that Trinidad and Tobago is TTO.
The UK based teams were relatively low users of our minor ailments service. It may be that the officials with these teams were more aware of the services and products that they could access outside the village and so obtained any necessary services there. There may be other reasons for the differences in accessing such services, eg reduced incidence of illness due to less travelling or being more prepared for conditions each person was likely to suffer from such as hay fever or insect bites.
There were 105 issues of products and a total of 30 different products supplied under the scheme. The most common products issued were analgesics and anti-inflammatory products with around one-third of issues being for paracetamol or ibuprofen. Other conditions treated included hay fever, vaginal thrush, dry eyes, cold sores, conjunctivitis and mouth ulcers.
This was a very useful service to offer which reduced demand on the doctors and nurses within the polyclinic and encouraged one-step treatment for team officials for these minor conditions. Like the London service, this was not available to athletes. Any athlete with an illness had to be assessed by a doctor and a prescription written. Treating elite athletes at this kind of multisport event can be complex. There are many people involved in trying to ensure the athlete is in optimum health for their competition and of course there are concerns over potential violations of the world anti-doping agency prohibited list. None of the products available through our minor ailment service were prohibited in sport and there were a number of occasions when we had to refer an athlete to a doctor who then prescribed a product which otherwise we could have supplied.
One of our recommendations from this event would be to consider whether the service could be expanded to include athletes in future. This would need further discussion and agreement by the Commonwealth Games Federation Medical Commission. It may be that the service could be expanded in stages, eg to include athletes who have finished competition. This would further enhance the role of the pharmacy service and make additional use of the pharmacists’ skills in this area.