Community pharmacy management of minor conditions - The "Care at the chemist" scheme

AIM • To describe community pharmacy management of minor conditions after referral from one general practice. DESIGN • A single-centre, 26-week feasibility study in which all patients seeking GP appointments or telephone request for a prescription for 12 self-limiting conditions were offered a consultation with a community pharmacist. Pharmacists prescribed from a formulary with patients charged or exempt from charges, as for normal NHS prescriptions. SUBJECTS AND SETTINGS • Patients from one general practice were managed in eight local community pharmacies in Merseyside. OUTCOME MEASURES • Level of transfer to pharmacy management for the 12 conditions. Patient management within the pharmacies, including prescribing outcomes, referral back to the practice and reconsultation rates. RESULTS • Over the study period, 576 patients used the pharmacy scheme out of a total of 1,522 who contacted the practice with one of the 12 conditions. The conditions most frequently managed in the pharmacies were head lice, vaginal thrush and upper respiratory tract infections. These three conditions accounted for 79% of all referrals. Most patients (89%) were managed with advice and treatment prescribed from the formulary. Only 21 patients were referred back to the practice and 33 patients reconsulted for the same minor condition within 14 days. CONCLUSIONS • The scheme enabled the transfer of over one third of the workload for 12 minor conditions from one general practice to eight community pharmacies, but most of the consultations were for three of the conditions. The pharmacists were successfully able to manage a range of conditions from within a specifically designed formulary, and few patients required referral back to the practice. Further, reconsultation rates for the same condition were low.