title: Design of an algorithm to support community pharmacy dyspepsia management.
abstract: OBJECTIVE
  To design a care pathway and referral documentation system to support dyspepsia management in the community pharmacy according to national guidelines. To explore attitudes of community pharmacists and general practitioners (GPs) towards the proposed model of care.
  
  
  METHODS
  Focus group of four community pharmacists from one locality and one-to-one interviews with five GPs in each of their surgeries in different city localities.
  
  
  METHODS
  Literature review; design of a care pathway and referral system; qualitative analysis of focus group discussion and one-to-one interviews.
  
  
  METHODS
  Modified design of documentation system; attitudes and barriers towards an extended role for pharmacists in a community pharmacy based model of individual care of patients with dyspepsia.
  
  
  RESULTS
  The care pathway and documentation system was modified to make it simple to use and to assure appropriate referral and reporting to GPs. All participants agreed that the SIGN guideline for Dyspepsia and local dyspepsia guidelines provide an opportunity to extend the role of pharmacists to prescribe therapeutic doses of H2 receptor antagonists, test for Helicobacter pylori in the pharmacy and prescribe eradication therapy. Perceived advantages to patients included better convenience and reduced waiting times for H. pylori testing. Current barriers to this model identified were: medico-legal issues, budgetary issues, limited access to patient data, lack of privacy to talk to patients, inadequate time and remuneration, no patient registration, patients describing vague symptoms and patient confidence in pharmacists.
  
  
  CONCLUSIONS
  The proposed model of care and documentation system for community pharmacy based dyspepsia management generated a favourable response and design contributions from community pharmacists and GPs. Barriers were identified which have to be overcome prior to implementation and evaluation of the model.
authors.affiliation: NHS Lothian Pharmacy Practice Unit, Department of Pharmacy, Western General Hospital, Crewe Road, Edinburgh, Scotland. halldora.aradottir@encode.is
authors.forename: Halldora A E
authors.initials: HA
authors.lastname: Aradottir
authors.forename: Moira
authors.initials: M
authors.lastname: Kinnear
mesh_terms: D000465:Algorithms; D003157:Community Pharmacy Services / Q000458:organization & administration*; D003625:Data Collection; D004282:Documentation / Q000379:methods; D004415:Dyspepsia / Q000188:drug therapy* / Q000382:microbiology; D017144:Focus Groups; D016481:Helicobacter Infections / Q000188:drug therapy; D016480:Helicobacter pylori / Q000302:isolation & purification; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D017146:Models, Organizational; D005791:Patient Care / Q000379:methods; D010595:Pharmacists / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D024382:Professional Role; D012017:Referral and Consultation / Q000458:organization & administration*
chemical_list: D006635:Histamine H2 Antagonists