Identification of patients attending Accident and Emergency who may be suitable for treatment by a pharmacist

Bednall, Ruth; McRobbie, Duncan; Duncan, John; Williams, David A.

doi:10.1093/fampra/20.1.54

Cited by 29 publications

(23 citation statements)

References 4 publications

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“…It depends on the definition and of the contextual factors, if consultations are estimated as “Minor Ailments”. In the available literature the percentage of minor ailments varies from 8 to 40% [15, 17, 29–33]. …”

Section: Discussionmentioning

confidence: 99%

Out of hours care in Germany - High utilization by adult patients with minor ailments?

et al. 2017

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BackgroundFamily practitioners (FPs) who work in Out-Of-Hours Care (OOHC) - especially in rural areas – complain about high workload related to low urgency and potentially unnecessary patient presentations with minor ailments. The aim of this study was to describe Reasons for Encounter (RFEs) in primary OOHC taken into account the doctor’s perspective in the context of high workload without knowing patients’ motives for visiting an OOHC-centre.MethodsWithin this descriptive study, OOHC data from 2012 were evaluated from a German statutory health insurance company in the federal state of Baden-Wuerttemberg. 1.53 Million of the 10.5 Million inhabitants of Baden-Wuerttemberg were covered. The frequency of the ICD-10 diagnoses was determined at the three- and four-digit-level. The rate of hospitalizations was used to estimate the severity of the evaluated cases.ResultsTaken as a whole, 163,711 reasons for encounter with 1,174 ICD-10 single diagnoses were documented, of these 62.2% were on weekends. Less than 5.0% of the examined patients were hospitalized. Low back pain-dorsalgia (M54) was the most common diagnosis in OOHC, with 10,843 cases. Injuries were found twelve times in the list of the 30 most frequent diagnoses. The most frequent infectious disease was acute upper respiratory infection of multiple and unspecified sites (J06). By analysing the ICD codes to four-digits and looking at the rate of hospitalizations, it can be assumed that many RFEs were of less urgency in terms of the prompt need for medical treatment.ConclusionWhile it is acknowledged that it can be difficult to make an exact diagnosis in an OOHC setting, after analysing the ICD-10 diagnoses, the majority of reasons for encounter in OOHC were determined to be of low urgency, meaning that patients could have waited until regular consultation hours. In the OOHC setting, it is important to understand RFEs from both the patient perspective and the family practitioner perspective. Additionally, results like these can be used in staff education especially improving triage methods and medical recommendations and in developing specific guidelines for OOHC in Germany. Analysis of routine data, such as in this study, contributes to this understanding and contributes to resolving problems of coding.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-017-0609-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Out of hours care in Germany - High utilization by adult patients with minor ailments?

et al. 2017

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“…However, 42% of those could have also been handled by a community pharmacist. 4 Hammond et al found that GPs felt that 7% of their cases could have been handled by a community pharmacist. 5 Therefore, primary health care would greatly benefit from a low-threshold entry into the health care system, as offered by telemedicine or pharmacies, where efficient primary triage would then treat or dispatch patients to the appropriated setting according to the severity and urgency of the cases.…”

Section: Introductionmentioning

confidence: 99%

netCare, a new collaborative primary health care service based in Swiss community pharmacies

Erni¹,

Overbeck²,

Reich

et al. 2016

Research in Social and Administrative Pharmacy

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“…[1][2][3][4][5] Up to 18% of general practice workload is estimated to relate to minor ailments, at a cost of £2 billion annually. 6 Similarly, 8% of emergency department consultations involve consultations each year for minor ailments, 7 costing the NHS £136 million annually. Research shows that GPs are in favour of diverting the care of minor ailments to other areas of primary care, including community pharmacists.…”

Section: Introductionmentioning

confidence: 99%

Are pharmacy-based minor ailment schemes a substitute for other service providers?

et al. 2013

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Background 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. Aim This study aimed to explore the effect of PMASs on patient health- and cost-related outcomes; and their impact on general practices. Design and setting Community pharmacy-based systematic review. Method 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. Results 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. Conclusion 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

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Identification of patients attending Accident and Emergency who may be suitable for treatment by a pharmacist

Abstract: A pharmacist could manage an estimated 8% of adult attendances at this A&E department. Efforts should be made to increase the awareness of the general public of the role of a community pharmacist to reduce demand on A&E and GP services.

Cited by 29 publications

References 4 publications

Out of hours care in Germany - High utilization by adult patients with minor ailments?

Out of hours care in Germany - High utilization by adult patients with minor ailments?

netCare, a new collaborative primary health care service based in Swiss community pharmacies

Are pharmacy-based minor ailment schemes a substitute for other service providers?

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