Managing minor ailments: Patients’ health-seeking behaviour and the role of community pharmacy

Watson, Max; Holland, Richard; Ferguson, John; Porteous, Terry; Sach, Tracey; Cleland, Jennifer; Bond, Christine; Wright, D.

doi:10.1016/j.sapharm.2014.07.082

Cited by 7 publications

(14 citation statements)

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“…The above groups of symptoms were chosen because they have previously been identified as occurring frequently within EDs and general practices. 5 …”

Section: Methodsmentioning

confidence: 99%

“… 15 A minimum of 81 participants were required per setting. The prevalence of minor ailments was anticipated to be higher in community pharmacies and general practices 5 compared with EDs. As such, recruitment targets for the higher prevalence sites were set at 160 participants and from the EDs were 80.…”

Section: Methodsmentioning

confidence: 99%

“… 4 Recent estimates suggest that 5% and 13% of consultations in ED and general practice, respectively, are for minor ailments that could be managed in community pharmacies. 5 For the purpose of this study, minor ailments are “common or self-limiting or uncomplicated conditions which may be diagnosed and managed without medical (ie, doctor) intervention.” 6…”

Section: Introductionmentioning

confidence: 99%

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A cohort study of influences, health outcomes and costs of patients’ health-seeking behaviour for minor ailments from primary and emergency care settings

et al. 2015

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ObjectivesTo compare health-related and cost-related outcomes of consultations for symptoms suggestive of minor ailments in emergency departments (EDs), general practices and community pharmacies.DesignObservational study; prospective cohort design.SettingEDs (n=2), general practices (n=6) and community pharmacies (n=10) in a mix of rural/urban and deprived/affluent areas across North East Scotland and East Anglia. Participants Adults (≥18 years) presenting between 09:00 and 18:00 (Monday–Friday) in general practices and 09:00–18:00 (Monday–Saturday) in pharmacies and EDs with ≥1 of the following: musculoskeletal pain; eye discomfort; gastrointestinal disturbance; or upper respiratory tract-related symptoms.InterventionsParticipants completed three questionnaires: baseline (prior to index consultation); satisfaction with index consultation and follow-up (2 weeks after index consultation).Main outcome measuresSymptom resolution, quality of life, costs, satisfaction and influences on care-seeking behaviour.Results377 patients participated, recruited from EDs (81), general practices (162) and community pharmacies (134). The 2-week response rate was 70% (264/377). Symptom resolution was similar across all three settings: ED (37.3%), general practice (35.7%) and pharmacy (44.3%). Mean overall costs per consultation were significantly lower for pharmacy (£29.30 (95% CI £21.60 to £37.00)) compared with general practice (£82.34 (95% CI £63.10 to £101.58)) and ED (£147.09 (95% CI £125.32 to £168.85)). Satisfaction varied across settings and by measure used. Compared with pharmacy and general practice use, ED use was significantly (p<0.001) associated with first episode and short duration of symptom(s), as well as higher levels of perceived seriousness and urgency for seeking care. Convenience of location was the most common reason for choice of consultation setting.ConclusionsThese results suggest similar health-related outcomes and substantially lower costs with pharmacy consultations for minor ailments. Effective strategies are now needed to shift demand for minor ailment management away from EDs and general practices to the community pharmacy setting.

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“…The above groups of symptoms were chosen because they have previously been identified as occurring frequently within EDs and general practices. 5 …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A cohort study of influences, health outcomes and costs of patients’ health-seeking behaviour for minor ailments from primary and emergency care settings

et al. 2015

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“…The costs per consultation were derived from the results of a recent cohort study ( 17 ) which compared the NHS and patient medication costs for an index consultation and 2-week follow-up, for patients deemed to have symptoms suggestive of minor ailments who presented in community pharmacies, EDs and general practices. The mean consultation cost was lowest for pharmacy participants and the mean incremental cost (compared with pharmacy) was estimated to be £113.62 (95% CI: £81.78–£145.47) for ED and £57.04 (95% CI: £34.95–£79.12) for general practice ( 17 ). As such, these were assumed to be the costs that would accrue if a person presented at the community pharmacy rather than general practice or ED.…”

Section: Methodsmentioning

confidence: 99%

“…The definition of ‘minor ailment’ used was: ‘common or self-limiting or uncomplicated conditions which can be diagnosed and managed without medical intervention’ ( 13 ). This study was one component of a larger programme of work, the MINA study (Community Pharmacy Management of Minor Illness) ( 17 ). The specific objectives here were to estimate the prevalence and type of consultations for minor ailments among adults seeking care in general practice and ED.…”

Section: Introductionmentioning

confidence: 99%

Estimating the burden of minor ailment consultations in general practices and emergency departments through retrospective review of routine data in North East Scotland

et al. 2015

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Background.Minor ailment attendances in general practices and emergency departments (EDs) place significant burden on health care resources.Objectives.To estimate the prevalence and type of minor ailment consultations for adults in general practice and ED that could be managed in a community pharmacy.Methods.Retrospective review of routine data from general practices (n = 2) and one ED in North East Scotland. Two independent consensus panels assessed each consultation summary to determine whether it represented a minor ailment. Outcomes included prevalence of consultations for minor ailments in general practice and ED and frequency of different minor ailment type that could be managed in community pharmacies.Results.In total, of the 494 general practice and 550 ED consultations assessed, 13.2% [95% confidence interval (CI): 18.6–25.9%] and 5.3% (95% CI: 4.0–8.0%), respectively, were categorized as minor ailments suitable for management in community pharmacies. Consensus among panel members was moderate for general practice consultations, but fair to poor for ED consultations. Agreement between uni- and multi-disciplinary panels was good. Applied to national data, these estimates would equate to ~18 million general practice and 6500000 ED consultations that could be redirected to community pharmacy, equating to ~£1.1 billion in resources.Conclusion.Minor ailment consultations still present a major burden on higher cost settings. Effective strategies are needed to raise awareness among patients and health professionals regarding conditions that can be managed effectively in pharmacies and to change patient health-seeking behaviour for such conditions.

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Unit cost of common illness management: a comparison between a primary care unit and a community pharmacy in Thailand

Saramunee

Ploylearmsang

Chaiyasong

et al. 2017

Prim Health Care Res Dev

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A primary care service of one educational institution was a study site. Eight common illnesses were emphasised. Patient visits were observed, prospectively at community pharmacy and retrospectively at PCU, during August to October 2013. Labour and material costs related to management of common illnesses were recorded. Total cost divided by total patient visits determined the unit cost. For the community pharmacy, patients were followed up after 3-14 days of visit to evaluate the effectiveness. Sensitivity analysis was performed by varying direct medical cost at ±10-30%. Findings At the community pharmacy, community pharmacists performed multiple tasks including interviewing and assessing patients, choosing an appropriate treatment and dispensing. Of 9141 visits, 775 (8.5%) with common illnesses were included. Upper respiratory disorder was found the highest 41.9% (325/755). Unit cost of treatment ranged from 54.16 baht (£1.18) for pain to 82.71 baht (£1.80) for skin disorder. Two-thirds of pharmacy visits (77.9%, 539/692) reported complete recovery. Managing common illnesses at the PCU was performed by nurse assistants, nurses, doctors and pharmacists. Of 6701 patient visits to the PCU, 1545 (23.1%) visits were at least one of the eight illnesses. Upper respiratory disorder was the majority, 53.0% (771/1454). Unit cost of treatment ranged from 85.39 baht (£1.86) for eye/ear to 245.93 baht (£5.36) for sexual health. Managing common illness at a community pharmacy shows satisfactory effectiveness with lower unit cost.

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Managing minor ailments: Patients’ health-seeking behaviour and the role of community pharmacy

Cited by 7 publications

References 0 publications

A cohort study of influences, health outcomes and costs of patients’ health-seeking behaviour for minor ailments from primary and emergency care settings

A cohort study of influences, health outcomes and costs of patients’ health-seeking behaviour for minor ailments from primary and emergency care settings

Estimating the burden of minor ailment consultations in general practices and emergency departments through retrospective review of routine data in North East Scotland

Unit cost of common illness management: a comparison between a primary care unit and a community pharmacy in Thailand

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