Treatment of minor ailments and wound care requires review

Wound care and the treatment of minor ailments are important professional services provided by your local pharmacist, writes Grant Kardachi, president of the Pharmaceutical Society of Australia.
Grant Kardachi was elected President of the PSA after serving as Vice President and a Board Member for three years. He is a community pharmacist who recently sold his business interests but is still accredited to undertake medication reviews and sits on the Australian Association of Consultant Pharmacy.
“What is clear is that the services that we already provide in the treatment of minor ailments are valued by those customers who receive them.”
Grant Kardachi
Research shows that the treatment of minor ailments including wound care represents about 20-30 per cent of the turnover of most pharmacies, which is not surprising given that pharmacists are still the most accessible health-care professionals.
However, a report published in The Annals of Pharmacotherapy underlined that there are some shortcomings with most pharmacies in their current ad hoc and informal procedures when it comes to treating patients who present with minor ailments.
The report made it clear that this is a failing that damages the reputation of pharmacists as providers of minor ailment treatment, particularly where a referral to a medical practitioner is deemed necessary.
“All medial referral advice was provided verbally to the simulated patient; no pharmacy provided a written referral or contacted a physician on a patient’s behalf,” the report states. Further on, it states: “Correct processing of the gathered information is required after assessment takes place”.
The report also points out that outcomes were significantly improved when a pharmacist, rather than a pharmacy assistant, was directly involved.
“...an appropriate outcome was less likely when the pharmacist was merely consulted by the assistant (ie the pharmacist did not have direct involvement). An effective patient transfer from assistant to pharmacist achieved an improve outcome in this study.”
Using such failures as a basis, the report sums up by saying this highlights the need for pharmacists to ensure that processes are in place for patients to access the pharmacist. Improved assessment and decision making are required to ensure that community pharmacy provides quality primary health care to patients with chronic conditions.
PSA has been a strong advocate for the change in the current business model of community pharmacies with the incorporation of an additional pharmacist permanently located in the front of shop. Much evidence already exists as to the cost-effectiveness of such a move and this new research simply reinforces the improved health outcomes that are likely to flow to the patient from such a move.
The all-too-common 30-second process of matching a symptom to a product is hardly what could be construed as being a professional service and it is long overdue that we took this professional role far more seriously in this area.
What is clear is that the services that we already provide in the treatment of minor ailments are valued by those customers who receive them. But the ad hoc nature of these services lets us down and does little justice to the profession.
The extent of just how we can better make use of the huge potential in the treatment of minor ailments is highlighted by a recent Nielsen study shows that 71 per cent of Australians are willing to use the pharmacist as first point of contact for health concerns.
We have to translate the ‘are willing’ into ‘will’ come to a pharmacist for treatment and a more formalised and structured approach is a good way to start on the road to achieving this.
According to a working group report instigated by PSA, the provision of a minor ailment service should be performed by a pharmacist taking a brief patient history, following practice guidelines with specific assessment tools, providing appropriate treatment products and information such as the Self Care Fact Cards, documenting the details through relevant software, and if necessary, performing a formal referral process to the patient’s GP.
As pharmacies take on this greater professional role, practice change is required to ensure that it is carried out effectively. This includes a private counselling area and for the pharmacy to present as a solution for the health problems of the Australian public.
To further add to the robustness of such service provision, we may need to examine some form of accreditation that the service is being provided according to the agreed guidelines. This would be particularly relevant if the services were to be suitably remunerated.
We must also be aware that we cannot develop any formalised approach to minor ailment treatment in isolation. We need to work closely with our GP colleagues to ensure they accept our triage role and they recognise benefits that will flow from a formal referral process.
Of course, ultimately it is the patient who will decide where they go for treatment. PSA is keen to ensure that this area of minor ailment treatment assumes a much greater degree of formality resulting in pharmacists being rightfully recognised and rewarded for the valued service they provide in both treating and triaging these patients.
“... 71 per cent of Australians are willing to use the pharmacist as first point of contact for health concerns.”
Grant Kardachi