Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Pharmaceutical Care Research Group, University of Granada, Granada, Spain.
PLoS One. 2022 Oct 25;17(10):e0275252. doi: 10.1371/journal.pone.0275252. eCollection 2022.
Self-perceived minor ailments might conceal other health conditions if patients are not appropriately assisted by health care professionals. The aim of the study was to evaluate the patient-related outcomes of a community pharmacy Minor Ailment Service (MAS) compared to usual pharmacist care (UC).
A cluster randomised controlled trial was conducted over six months in community pharmacy in the province of Valencia (Spain). Patients seeking care or requesting a product for a minor ailments considered in the study (dermatological problems, gastrointestinal disturbance, pain and upper respiratory tract related symptoms) were included. The intervention consisted of a standardised pharmacist-patient consultation guided by a web-based program using co-developed management protocols and patients' educational material. Patients were followed up by phone ten days later. Primary clinical outcomes were appropriate medical referral and modification of direct product request. Secondary outcomes were symptom resolution and reconsultation rates.
A total of 808 patients (323 MAS and 485 UC) were recruited in 27 pharmacies of 21 municipalities. Patients visiting MAS pharmacies had higher odds for being referred to a physician (OR = 2.343, CI95% = [1.146-4.792]) and higher reconsultation rates (OR = 1.833, CI95% = [1.151-2.919]) compared to UC. No significant differences between groups were observed for modification of direct product request and symptom resolution.
The use of management protocols through the MAS strengthened the identification of referral criteria such as red flags in patients suffering minor ailments. These patients with symptoms of minor ailments possibly due to more severe illness were to be referred and evaluated by physicians. Results reinforce that MAS increases safety for those patients consulting in community pharmacy for minor ailments.
Trial registration number: ISRCTN17235323. Retrospectively registered 07/05/2021, https://www.isrctn.com/ISRCTN17235323.
如果患者得不到医疗保健专业人员的适当帮助，自我感知的小病可能隐藏着其他健康问题。本研究的目的是评估社区药房小病服务（MAS）与常规药剂师护理（UC）相比患者相关结局。
在西班牙巴伦西亚省的社区药房进行了一项为期六个月的集群随机对照试验。纳入因研究中考虑的小病（皮肤病问题、胃肠道紊乱、疼痛和上呼吸道相关症状）寻求护理或要求使用产品的患者。干预措施包括由基于网络的程序指导的标准化药剂师-患者咨询，该程序使用共同制定的管理方案和患者教育材料。患者在 10 天后通过电话进行随访。主要临床结局是适当的医疗转诊和直接产品请求的修改。次要结局是症状缓解和再就诊率。
共招募了 808 名患者（MAS 组 323 名，UC 组 485 名），来自 21 个市镇的 27 家药房。与 UC 相比，到 MAS 药房就诊的患者更有可能被转介给医生（OR = 2.343，95%CI = [1.146-4.792]），且再就诊率更高（OR = 1.833，95%CI = [1.151-2.919]）。两组间在直接产品请求的修改和症状缓解方面无显著差异。
通过 MAS 使用管理方案加强了对患者出现转诊标准的识别，如患有小病的患者出现的危险信号。这些患有可能因更严重疾病引起的小病症状的患者将被转介并由医生进行评估。结果表明，MAS 增加了社区药房中小病患者的安全性。
试验注册号：ISRCTN17235323。回顾性注册于 2021 年 7 月 5 日，https://www.isrctn.com/ISRCTN17235323。
