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Leading pharmacy expert renews call for structured community pharmacy scheme for common minor ailments

Pharmacies are very important for non-prescription medicines and self-care models, says Professor Charlie Benrimoj, Head of the UTS Graduate School of Health.

He shared the importance of self-care, and ideas on cultivating a structured minor ailments scheme in community pharmacies, with delegates at the World Self Medication Industry General Assembly on October 18.

A minor ailments scheme is a locally tailored, structured community pharmacy based service where individuals are encouraged to seek pharmacist care to manage their minor ailment symptoms in an effective and timely manner, explains Professor Benrimoj.

While such a scheme has been on the agenda for years, it’s yet to be fully implemented in Australia.

The scheme can be established locally or nationally where the pharmacist is the first port of call for a common minor ailment, and acts in accordance with structured local/national guidelines, and can be driven through either a local or national strategy.

However the idea has previously received criticism from medical practitioners.

For example, early last year GP Dr Evan Ackermann wrote in MJA InSight that a minor ailments scheme would be “a push by the pharmaceutical industry and pharmacy business to increase drug sales under the guise of health innovation”.

Melbourne pharmacist Jarrod McMaugh responded a counter piece that the “minor ailments scheme is a proposed funding model that would recognise the role that pharmacists in community settings have provided on a daily basis since the inception of pharmacy degrees.”

Pharmacists already provide minor ailment services, often foregoing sales when the purchase of pharmacy products is not in the patient’s best interest, he added.

Such schemes have already been implemented in the UK and Canada.

Minor ailments covered in the UK include: backache, sprains and strains; colds; conjunctivitis; constipation; coughs; diarrhoea; earache; haemorrhoids; hay fever; head lice; headache and fever; heartburn and indigestion; insect bites and stings; mild eczema and dermatitis; minor fungal skin infections; mouth ulcers; nappy rash; sore throat; teething; threadworm; thrush.

Minor ailments schemes would see a huge burden lifted from GPs and the healthcare system, says Professor Benrimoj.

“What has been driving these schemes has not been research, but policy work – normally driven by heath economics – about how much the country would save from people going to see the pharmacist instead of GP or emergency department, he explains.

“And instead of buying a prescription product they’re buying a non-prescription one.

“The good thing about them is they integrate into primary care. In the UK there’s about 36 minor ailments (an average of 20 conditions) with analgesics the most commonly dispensed items related to the scheme.”

Data based on minor ailments services in England reveals that of 1.7 million patient consultations using 74 services, 87% would have attended their GP surgery if the service wasn’t there.

And 98% of minor ailments scheme users required no onward referral – patients were provided with appropriate advice and medicines without further need for referral.

“For these things to work, they have to work at a local level. In Australia, the PHNs are pretty good and we need to look at that. But what we want is a policy environment to accelerate these local initiatives,” says Professor Benrimoj.

“There’s a massive opportunity to increase consumer self care and self efficacy. This would also help take pressure off the healthcare system.”

While Australia’s burgeoning non-prescription market is “roughly half the size of the PBS”, Professor Benrimoj also points out that the government has no formal health policy on it, and suggests it should be integrated into the national health policy.

“A large number of patients want to be involved in decision making about health outcomes – but I don’t think we’re actually doing that well right now,” he said, arguing that the market has developed in an “unstructured” way.

“It’s about tapping into the current behaviours and giving them structure. One of the biggest issues is that self care – including use of non-prescription medications – is not currently integrated into the healthcare system.”

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