By Dr Soha Dattani BDS MSc(Hons) MRD RCS and Kavita Datar MRPharmS
1. Patients often visit their GP with self-treatable conditions with the anticipation antibiotics will be prescribed
2. Whilst shoppers trust the advice of the pharmacist they are often reluctant to waste the pharmacist’s time
3. Self-care presents pharmacy with the opportunity to support effective symptom relief whilst acting as antimicrobial stewards
The self-care agenda is often mentioned in Government policy as an opportunity to save the health service millions of pounds annually, by empowering patients to take more control over their lives.
According to the Department of Health an estimated 18 million GP visits are spent dealing with minor, self-treatable illnesses. Pharmacists providing advice on the treatment for these minor illnesses, as well as chronic conditions, could deliver savings of over £1.5bn each year which could be reinvested into the health service.
But what does this actually mean in practical terms for us as pharmacists?
Self-care presents the pharmacy team with an additional opportunity to support our patients beyond dispensing prescriptions or selling over the counter medicines.
The network of 11,000 brick and mortar pharmacies means we are a hugely accessible resource for people with health concerns, resulting in over 1.6m visits to pharmacies every year: 1.2m of which are for health-related concerns.
For example during the winter months when GP and A&E services are under huge pressure, the fact that people only need to wait on average less than 5 minutes to speak with a pharmacist about winter ailments, versus a 3.5-day average wait to see the GP, means the advice we offer can have significant positive impacts for both ourpatients and the wider health system.
But more than just expert advice, the pharmacy team can help patients better manage their symptoms through P-line products, bigger pack sizes and higher strength products – often unique to the pharmacy setting. This is the real differentiator pharmacies have versus the high street and online retailers, and arguably one of our biggest strengths.
Many people will visit the pharmacy to seek advice on how best to manage their cold or flu symptoms and, therefore, this encounter is an essential opportunity for pharmacists to play their part as antimicrobial stewards and discourage antibiotic seeking behaviours
However many patients are reluctant to waste the pharmacist’s time perceiving pharmacy staff are very busy.
As a result, almost one third of shoppers walk away from the pharmacy without purchasing a relevant product and 40% are unaware of products behind the pharmacy counter.
We need to make sure our teams reach out to customers who are in our pharmacy to maximise these opportunities.
Despite pharmacy shoppers looking for (and trusting) advice from the pharmacy team, many are not proactively engaging with patients presenting with minor ailments, such as colds or flu.
So, the pharmacy team need to seize the initiative by engaging with patients to better understand their symptoms in order to recommend the best product for their needs.
This not only delivers to the self-care agenda but can drive sales and position pharmacies, and our teams, as a crucial link in antimicrobial stewardship.
There is no doubt that antibiotics havesaved millions of lives since they were discovered, but no new classes of antibiotics have been made available since the 1980s. This, combined with increased and inappropriate use of the antibiotics we have, has led to a situation where antimicrobial resistance is rapidly becoming a major public health concern and the rising resistance to antibiotics has become a threat to public health.
Globally 700,000 people are estimated to die each year from drug-resistant infections, and this is rapidly becoming a significant challenge for the health community.
But when a large percentage of the wider general public still believe antibiotics are effective in the treatment of colds & flu, and many present to the GP with the expectation of being prescribed antibiotics for that precise purpose, community pharmacy needs to be effective stewards in the fight against antimicrobial resistance.
As the winter season approaches the number of people seeking the advice of the pharmacy team regarding the symptoms of cold or flu will certainly increase. Research conducted by the Royal Pharmaceutical Society found that on average community pharmacies saw 6–10 patients with cold or flu symptoms every day during the season.
The pharmacy team have an essential role in discouraging the inappropriate use of antibiotics that could contribute to antimicrobial resistance, promote prevention and the role of self-care, and deliver public health messages
So, is it possible to balance the self-care agenda with an effective approach to antimicrobial stewardship?
Research investigating patient behaviour whilst suffering from cold or flu illustrates nearly a quarter (23%) of sufferers will seek to treat symptoms within the first 3 days of the illness and it is here that arguably the Pharmacy team can be most effective.
Research conducted as part of the Treat Yourself Better launch indicated patients clearly underestimate the duration of winter ailments with 98% incorrectly believing a cough should only last on average 8 days and 80% expecting flu symptoms to last 10 days. Over a third (36%) of sufferers also stop taking their cold and flu medication before they get better.
Symptoms of a cough can last for up to 3 weeks, whilst the normal duration of flu symptoms is 2 weeks.
Subsequently patients often visit their GP too early with the anticipation that antibiotics will be prescribed.
The pharmacy team can play acrucial role in reducing the number of GP appointments used (and subsequent cost to the NHS) by patients presenting with colds or flu, whilst discouraging the inappropriate use of antibiotics. However, to be effective all members of the team need to feel suitably confident in providing expert advice, including managing patient expectations regarding the natural duration of symptoms, and the role of OTC medications on managing symptoms.
700,000 people are estimated to die each year from drug-resistant infections,with an anticipated 3x rise in global antibiotic consumption predicted by 2030
Pharmacies have a huge opportunity to become antimicrobial stewards whilst supporting patients to more effective symptom relief.
As part of the self-care agenda we need to check appropriate antibiotic prescribing, whilst advising on good self-care of cold or flu symptoms without antibiotics. As such we will be ideally placed to take advantage of the changes within the NHS healthcare setting and secure a future for our pharmacies.
Become an antibiotic guardian and commit to these AMS efforts in your pharmacy by signing up at: https://antibioticguardian.com
Dr Soha Dattani, Director Scientific & Professional affairs, GSK.
Kavita Datar, Expert Markteting Manager Wellness, GSK.
Citation: The Pharmaceutical Journal, September 2019. doi: 10.1211/PJ.2019.20207111
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