Mantzourani Efi, Evans Andrew, Cannings-John Rebecca, Ahmed Haroon, Hood Kerenza, Reid Nicholas, Howe Robin, Williams Emma, Way Cheryl
School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
Primary Care, Information and Communications Technology, NHS Wales Informatics Service, Cardiff, UK.
BMJ Open Qual. 2020 Feb;9(1). doi: 10.1136/bmjoq-2019-000833.
A National Health Service (NHS)-funded sore throat test and treat (STTT) service was introduced in selected pharmacies in two local health boards in Wales, as an extension to the national pharmacy common ailment scheme. The aim of this study was to evaluate the impact of STTT on provision and quality of patient care, namely antibiotic use, patient safety and general practitioner (GP) consultation rates.
Secondary analyses of STTT consultation data to describe service outcomes, and routine data to explore changes in antibiotic prescribing and the prevalence of complications. Data were also collected from one GP practice to explore the feasibility of measuring changes in sore throat consultation rates in general practice.
Less than 20% of 1725 consultations resulted in antibiotic supply. The availability of STTT was associated with greater reductions in prescriptions for phenoxymethylpenicillin than in areas where STTT was not available (-3.8% and -3.4%, difference 0.4%). When pharmacy supplies were included, the reductions in the supply of the antibiotic were similar. No increase in the monthly number of incidents of quinsy was detected, and patients were appropriately referred to other healthcare professionals during pharmacy consultations. GP consultation rates since introduction of STTT were found to be lower than the equivalent monthly average since 2014.
Data from the first 5 months of the STTT service suggest that it may have a role in safely rebalancing uncomplicated sore throat management from general practice to community pharmacies while continuing to promote antibiotic stewardship.
作为国家药房常见疾病计划的延伸,威尔士两个地方卫生委员会在选定的药房推出了由国民医疗服务体系(NHS)资助的咽喉痛检测与治疗(STTT)服务。本研究的目的是评估STTT对患者护理的提供和质量的影响,即抗生素使用、患者安全和全科医生(GP)会诊率。
对STTT会诊数据进行二次分析以描述服务结果,并对常规数据进行分析以探索抗生素处方的变化和并发症的发生率。还从一个全科医生诊所收集数据,以探讨测量全科医疗中咽喉痛会诊率变化的可行性。
1725次会诊中不到20%导致了抗生素供应。与没有STTT的地区相比,STTT的可及性与青霉素V钾处方的更大降幅相关(分别为-3.8%和-3.4%,差值0.4%)。当包括药房供应时,抗生素供应的降幅相似。未检测到扁桃体周围脓肿每月发作次数增加,并且在药房会诊期间患者被适当地转诊给其他医疗专业人员。发现自引入STTT以来,全科医生会诊率低于2014年以来的月平均水平。
STTT服务前5个月的数据表明,它可能在安全地将单纯性咽喉痛管理从全科医疗重新平衡到社区药房方面发挥作用,同时继续促进抗生素管理。