What do Minor Ailments Schemes look like in practice internationally? Dr. Angel Gonzalez investigates
The pharmacy profession has aimed to transition from a distributive focus to a patient-centric care focus since the pioneering definition of pharmaceutical care published by Hepler and Strand in 1990.
The past decade in particular has seen a significant expansion of the pharmacists’ role through the implementation of clinical services such as minor ailments schemes, administration of prescriptions, medication therapy management programs and the newly acquired authority to administer drugs and vaccines by injection.
Community pharmacy staff have the capacity to support customers wishing to self-care for minor ailments and, if necessary, refer them onwards to appropriate healthcare professionals for further investigations.
Many countries promote this role, encouraging people to take responsibility for their own health and thus reducing the demand for more expensive healthcare options (such as appointments with primary care medical practitioners or visits to hospital emergency departments) and subsequently achieving better use of scarce public resources.
Below are brief reviews on how the community pharmacy is contributing to solving the burden of minor ailments in the healthcare systems in UK, Canada, and Switzerland.
The Community Pharmacy Minor Ailments Scheme (MAS), began in Scotland in 2005 and is now available in some pharmacies across the UK.
The primary health care role of the community pharmacist was formalised for certain minor ailments and elements of triage introduced.
This was done by allowing designated patients to consult a pharmacist and, if necessary, obtain a pharmacist-prescribed medication from a limited formulary.
In Canada, two provinces (Nova Scotia and Saskatchewan) added minor ailments as an expanded aspect of practice in 2011.
This new legislation broadened pharmacists’ scope of practice, enabling them to prescribe certain medications for minor self-limiting and self-diagnosed ailments from a list of agents limited previously to doctor’s prescription.
Pharmacists now have the option of selecting medications from a restricted formulary that were traditionally under the sole control of physicians. An example scenario would be a topical antifungal for a diaper rash or a cream retinoid/antibiotic for a patient with acne.
In 2012, the Swiss Pharmacists’ Association launched netCare, a primary triage service using a structured decision-tree for 24 common conditions, where pharmacists can request a real-time video consultation with a doctor if necessary.
In the netCare model, access to a dedicated GP to request a second opinion was used in only 17 % of cases.
With expanding pharmacist scopes of practice worldwide and diminishing revenues from dispensing activities it appears that clinical care services will take on a larger role in pharmacy business models of the future.
Some paradigms need to change: patient inclusion criteria needs to be sufficiently broad to ensure proper access, customers will need to acknowledge the cost of these new benefits in their primary care and pharmacists must make physical and workflow-related changes to their practices to be able to accommodate these increasingly important activities.
Dr. Angel Gonzalez is a Senior Associate with XPotential™ and Director of SymptoMapp. A qualified medical practitioner and anaesthetist in his home country, he is the owner of his own medical consulting business in Latin America. Angel’s deep medical knowledge, commitment to improving consumer health literacy and creativity provides unique insight into opportunities to improve healthcare in Australia.