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Pharmacies 'save GP time' by treating UTIs with antibiotics

Community pharmacists are able to diagnose and treat uncomplicated urinary tract infections (UTIs) appropriately, thereby saving both GPs and their patients time and resources, suggest the results of a pilot study.

The study

Ten community pharmacies within NHS Greater Glasgow and Clyde were invited to supply trimethoprim under a patient group direction (PGD) to patients with a moderate-to-severe UTIs meeting the PGD criteria. Patients and pharmacists completed questionnaires and were interviewed about their experience of the intervention.

The findings

Data were analysed for 153 patients, 97 presenting with GP prescriptions and 56 presenting directly to the pharmacy with symptoms suggestive of a UTI, of whom 41 received trimethoprim and 15 received symptomatic management. Of the patients given trimethoprim by the pharmacist, 31 (76%) met the PGD inclusion criteria, but 29 (71%) reported potential exclusions. However, the authors noted some exclusions could have been due to ambiguity in their questionnaire.

Around one-third of patients presenting at the pharmacy directly did so at the weekend, and on average those seeking pharmacy management presented a day earlier in the course of infection than those with GP prescriptions. Almost all the patients said they would prefer to attend the pharmacy because of difficulty obtaining a GP appointment and not wanting to trouble the GP with a non-emergency problem.

What this means for GPs

The researchers said their study showed pharmacies could improve access to antibiotic treatment for UTIs and reduce GP workloads. They write: ‘Operating within PGD controls, antibiotic treatments for UTIs could be provided via community pharmacy to improve patient access to treatment, which may also maintain antibiotic stewardship and reduce GP workload.’

Br J Gen Pr 2013; 63: e244-e249

Readers' comments (3)

  • this research is not worth the paper it is written on.first of all"were invited to supply trimethoprim under a patient group direction (PGD) "invited being the key word.was there an incentive attached?in twenty years of general practice i have never seen a sigle patient supplied or even invited to buy trimethoprim which as far as i know is an otc medication as of a few years ago.pharmacists should be doing this anyway but it is not worth their while is it?

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  • While I commend Pharmacies offering such services and reducing GPs workload, one needs to be mindful of how one might be perceived to be encouraging the use of antibiotics.

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  • Comment @ 9.25am Trimethoprim is not available OTC. Some areas had PGDs to treat uncomplicated cystitis, but most are now withdrawn. As for incentive, there would be a payment per consultation, which would likely have been independent of actually supplying the medicine i.e. would not have acted as an incentive to oversupply.

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