The role of community pharmacists in prescribing medication for the treatment of head lice.
BACKGROUND
The aim of the study was to discover whether the use of community pharmacy, rather than general practice, as the first port of call for suspected head lice infestation would represent an acceptable, effective and cost-reducing means of management in the community.


METHODS
A before-and-after study was carried out of a new system of care delivery. Between September and November 1997, pharmacists in Nottingham City West recorded details of all patients attending with prescriptions for head lice treatment or those purchasing over-the-counter medication. The new system of care delivery began in January 1998, during which, pharmacists were providing advice and treatment for head lice, in the absence of a referral from general practice. Changes in prescribing behaviour were assessed from Prescribing Analysis and Cost (PACT) data. Acceptability and subjective assessment of the scheme (patients and professionals) was gauged from questionnaires.


RESULTS
Referral patterns were altered drastically (away from general practice and towards self-referral) by the project, and the changes were apparent within the first month. This trend continued throughout and beyond the formal evaluation period. Cost analysis suggests that the community pharmacy scheme generates resource savings, largely driven by the lower cost of a pharmacy consultation, as opposed to a GP consultation. Questionnaire evidence suggests that both patients and health care professionals viewed the new arrangement as at least as acceptable as the old.


CONCLUSIONS
With respect to the original objective, the new delivery system appears to provide no evidence of ineffectiveness; evidence of acceptability on the part of the majority of patients and professionals; and evidence of improved cost-effectiveness.
Philips
Z
Z
Trent Institute for Health Services Research, University of Nottingham, Medical School. zoe.philips@nottingham.ac.uk
Whynes
D
D
Parnham
S
S
Slack
R
R
Earwicker
S
S
D000328:Adult; D000818:Animals; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002648:Child; D003157:Community Pharmacy Services / Q000458:organization & administration*; D003363:Cost Control; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000458:organization & administration*; D011307:Drug Prescriptions / Q000592:standards* / Q000706:statistics & numerical data; D004363:Drug Utilization; D004739:England; D005260:Female; D006801:Humans; D007587:Job Description; D010373:Lice Infestations / Q000188:drug therapy*; D008297:Male; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D010374:Pediculus; D015397:Program Evaluation; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012536:Scalp Dermatoses / Q000188:drug therapy*; D011795:Surveys and Questionnaires
D004366:Nonprescription Drugs