Estimating the burden of minor ailment consultations in general practices and emergency departments through retrospective review of routine data in North East Scotland.
BACKGROUND
Minor ailment attendances in general practices and emergency departments (EDs) place significant burden on health care resources.


OBJECTIVE
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.


CONCLUSIONS
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.
Medical Statistics Team and.
Shona
S
Fielding
Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen AB25 2ZD.
Terry
T
Porteous
Accident and Emergency Department, NHS Grampian, Foresterhill, Aberdeen AB25 2ZN and.
James
J
Ferguson
Department of Population Health and Primary Care, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK.
Vivienne
V
Maskrey
Department of Population Health and Primary Care, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK.
Annie
A
Blyth
Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen AB25 2ZD.
Vibhu
V
Paudyal
Department of Population Health and Primary Care, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK.
Garry
G
Barton
Department of Population Health and Primary Care, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK.
Richard
R
Holland
Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen AB25 2ZD.
Christine M
CM
Bond
Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen AB25 2ZD, m.c.watson@abdn.ac.uk.
Margaret C
MC
Watson
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D058006:General Practice / Q000191:economics / Q000706:statistics & numerical data*; D017048:Health Care Costs; D006300:Health Services Misuse / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D015588:Observer Variation; D010342:Patient Acceptance of Health Care; D010594:Pharmacies / Q000191:economics; D012189:Retrospective Studies; D012606:Scotland; D012720:Severity of Illness Index; D055815:Young Adult
Community pharmacy services; consensus; emergency departments; general practice.