It's not what you do it's the way that it's measured: quality assessment of minor ailment management in community pharmacies.
BACKGROUND
Effective management of minor ailments in community pharmacies could reduce the burden on alternative high-cost services (general practices, Emergency Departments). Evidence is needed regarding the appropriateness of management of these conditions in community pharmacies.


OBJECTIVE
To explore the appropriateness of minor ailment management in community pharmacies.


METHODS
Prospective, observational study of simulated patient (SP) visits to community pharmacies in Grampian (Scotland) and East Anglia (England).


METHODS
Eighteen pharmacies (nine per centre) were recruited within a 25-mile radius of Aberdeen or Norwich. Consultations for four minor ailments were evaluated: back pain; vomiting/diarrhoea; sore throat; and eye discomfort. Each pharmacy received one SP visit per ailment (four visits/pharmacy; 72 visits total). Visits were audio-recorded and SPs completed a data collection form immediately after each visit.


METHODS
Each SP consultation was assessed for appropriateness against product licence, practice guidelines and study-specific consensus standards developed by a multi-disciplinary consensus panel.


RESULTS
Evaluable data were available for 68/72 (94.4%) visits. Most (96%) visits resulted in the sale of a product; advice alone was the outcome of three visits. All product sales complied with the product licence, 52 (76%) visits complied with practice guidelines and seven visits achieved a 'basic' standard according to the consensus standard.


CONCLUSIONS
Appropriateness of care varied according to the standard used. Pharmacy-specific quality standards are needed which are realistic and relevant to the pharmacy context and which reflect legal and clinical guidelines to promote the safe and effective management of minor ailments in this setting.
Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
Jackie
J
Inch
Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
Terry
T
Porteous
Faculty of Medicine and Health, Norwich Medical School, Norwich Research Park, University of East Anglia, Norwich, UK.
Vivienne
V
Maskrey
Faculty of Medicine and Health, Norwich Medical School, Norwich Research Park, University of East Anglia, Norwich, UK.
Annie
A
Blyth
Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
Jackie
J
Burr
Division of Medical and Dental Education, John Simpson Chair of Medical Education, University of Aberdeen, Aberdeen, UK.
Jennifer
J
Cleland
School of Pharmacy, University of East Anglia, Norwich, UK.
David J
DJ
Wright
School of Medicine, Health Policy Practice, University of East Anglia, Norwich, UK.
Richard
R
Holland
Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
Christine M
CM
Bond
Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
Margaret C
MC
Watson
D001416:Back Pain / Q000628:therapy; D003157:Community Pharmacy Services / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D003967:Diarrhea / Q000628:therapy; D004636:Emergency Service, Hospital / Q000191:economics; D004739:England; D005128:Eye Diseases / Q000628:therapy; D005260:Female; D058006:General Practice / Q000191:economics; D019983:Guideline Adherence / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008297:Male; D016544:Patient Simulation; D010612:Pharyngitis / Q000628:therapy; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods*; D012017:Referral and Consultation / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D012606:Scotland; D014839:Vomiting / Q000628:therapy
community pharmacy services; health care; non-prescription medicines; quality indicators; self-care
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