Eye and ear care have long been well performing OTC categories yet with greater interaction and the benefit of S3 products up their sleeve, pharmacists can help guide customers on the most appropriate solution, writes Leanne Philpott
“While eye and ear care have not grown significantly in the last 12 months, the categories have performed very well with respect to the return on space and stock; above average in both cases. They achieve this because they take up comparatively very little space and stock investment, “ says Norman Thurecht, partner at Pitcher Pharmacy Services.
“Some pleasing outcomes from the last year include the fact that the average sale per customer is up to $14.46, which is above the total store average. The items per customer is also up to two, which is excellent given that the customer generally searches for and buys the solution,” he says.
Given the small size of eye and ear care products, the category can often look cluttered. This can make it difficult, especially for customers with poor vision, to shop. Thurecht says the obvious answer is to make the category bigger; pharmacies planning on doing this should start with their signage.
“After signage comes brand blocking and then the position in the pharmacy. It’s difficult to give the category top-rated space on the wall, given the small amount of space it actually takes up. When using a gondola, work it into the adjacencies of who the customer is and what else would they be buying,” advises Thurecht.
Pharmacist Rachael Starkey from Terry White Chemists Rockhampton, says, “Shelf talkers assist customers navigate the sea of lubricating drops, contact lens solutions and other treatments. In Queensland, our schedule two drops are behind the counter whereas in other states, the use of shelf talkers to help educate and offer hints such as the importance of short-term use only for vasoconstrictor-containing drops would be helpful.
“We train all staff on drops and have some “go-to” products to recommend that are highly effective. Depending on the situation, single use vials or drops with a preservative allowing use for up to six months use after opening is often a better option for occasional dry eye sufferers.”
Starkey adds that while people do tend to self-treat minor eye and ear care conditions, self-treatment can be used as an opportunity to educate customers on the importance of good general eye and ear health.
She says, “Tell them about in-store hearing checks to enable preventative follow up and minimise the risk of future hearing problems. Eye care is often about managing allergies, so it is important to educate on avoiding use of vasoconstrictor ingredients long-term. Often customers are not aware that use for longer than five days causes rebound congestion and redness and can increase intraocular pressure, which may in time increase their risk of developing conditions such as glaucoma.
“Ongoing allergies may require further testing to determine causes so that allergens can be avoided. Pharmacists can assist with symptom management by recommending intranasal corticosteroid sprays, oral antihistamines and provide useful lifestyle strategies to avoid allergens.
“In order to grow the category it is important to offer the full range of solutions and appropriate treatment. Dry eye and allergies are often ongoing conditions and if you provide an effective treatment and great service customers will keep coming back, not only for their monthly supply, but also for their other pharmacy-related items.
Thurecht agrees, “[Customer service] is a key factor in making the right product recommendation and connecting with the customer.
“If the pharmacy just wants to run a self select, product-at-a-price strategy, for example warehouse style, that’s alright too but the bundle size will only be based on price, not the solution for the customer through expert interaction.”
Common ear conditions
“Thanks to the humid climate of North Queensland, swimmers ear prevention and management is common. Pain relief drops are useful in offering relief for customers until they see their GP, or when referral for further treatment is required. It is important to educate customers that ongoing and untreated ear infections can lead to hearing problems in the future. Customers presenting with persistent and recurring ear infections should visit their doctor as soon as possible,” says Starkey.
She adds, “At Terry White Chemists Rockhampton we have regular ‘Australian Hearing’ clinic days every quarter and this allows our customers to access a service they may otherwise not without the convenience of being in-store while they wait for scripts. We take bookings and allow for “walk-ins” to add to the convenience and to ensure it is available to as many customers as possible. We pride ourselves on being a health destination pharmacy providing a range of professional services under the one roof.”
She tells The AJP, “Overseas, pharmacies like Walgreens and CVS offer ear wax removal and flushing services. That would be a useful service here in Australia and would be in keeping with the increasing scope of pharmacists such as the introduction of pharmacist-administered immunization. Pharmacists are easily accessible and with further expanding of our scope of practice we can relieve workload and costs to the health system and free up doctors waiting rooms for other more specialised procedures.”
Kevin de Vries, resource development pharmacist at The Pharmacy Guild of Australia, warns, “Ear candles are dangerous and quackery. Pharmacists should not sell them. They have no place in therapy, they do not work and they discredit and degrade the professional standing of our health profession.
“There are few conditions of the ear which pharmacists should attempt to treat. Perhaps minor bleeding due to scratches or minor injury or applying hydrocortisone cream to insect bites. That’s all. Everything else should be referred.”
He adds that there are a few devices, such as ear thermometers and syringes, which should be clearly demonstrated to parents, grandparents and carers so they know how to use them effectively.
“Some have idiosyncrasies that make them difficult to use,“ he says.
“Through working with our local health network we ensure we stock the eye and ear care products that best assist their clients. That way they know their patients can come to us and we will have the products available on the day and can provide the professional advice required to ensure effective treatment and the best possible health outcomes,” Starkey says.
No more antibiotics for kids with ear infection
As part of the NPS MedicineWise Choosing Wisely Campaign, a number of medical colleges have weighed in on areas of inappropriate treatment. As such they have recommended against the use of antibiotics to treat ear pain in children aged two to 12.
Dr Justin Coleman, chair of the RACGP Choosing Wisely initiative explains, “Despite understandable hopes and expectations, antibiotics seem to have a very limited effect on altering the natural course of pain due to ear infections in children.
“The past decade has seen some high-quality, large studies and systematic reviews. Antibiotics have no effect on pain at 24 hours, and no effect on pain, resolution or complications at seven days and beyond. In between, they have a slight benefit, with an NNT of 20 children treated to prevent one child with ear pain. This benefit should be weighed up against the risks for that child. In most (but not all) cases, that balance does not favour antibiotic use.”
He says pharmacists should recommend simple analgesics, such as paracetamol and NSAIDs, to treat ear pain.
Despite already being standard practice in some other countries, the Choosing Wisely recommendation will be new to many parents—and some doctors in Australia.
Dr Coleman’s advice for pharmacists is that, “Parents need to hear that the recommendation is actually in the best interests of their child’s health and wellbeing during this current bout of ear pain, rather than just some broader agenda regarding cost or antibiotic resistance.
“Parents want their child to be pain-free tomorrow, and to avoid complications, and so do we. It’s just that, unfortunately, providing antibiotics does not change the odds for these.
“Every child with ear pain should still be examined by a doctor, because the safe use of this recommendation requires a careful history and examination to identify cases where antibiotics remain necessary.”