A feasibility service evaluation of screening and treatment of group A streptococcal pharyngitis in community pharmacies

Abstract

ObjectivesThe UK 5 year antimicrobial resistance strategy recognizes the role of point-of-care diagnostics to identify where antimicrobials are required, as well as to assess the appropriateness of the diagnosis and treatment. A sore throat test-and-treat service was introduced in 35 community pharmacies across two localities in England during 2014–15.MethodsTrained pharmacy staff assessed patients presenting with a sore throat using the Centor scoring system and patients meeting three or all four of the criteria were offered a throat swab test for Streptococcus pyogenes, Lancefield group A streptococci. Patients with a positive throat swab test were offered antibiotic treatment.ResultsFollowing screening by pharmacy staff, 149/367 (40.6%) patients were eligible for throat swab testing. Of these, only 36/149 (24.2%) were positive for group A streptococci. Antibiotics were supplied to 9.8% (n = 36/367) of all patients accessing the service. Just under half of patients that were not showing signs of a bacterial infection (60/123, 48.8%) would have gone to their general practitioner if the service had not been available.ConclusionsThis study has shown that it is feasible to deliver a community-pharmacy-based screening and treatment service using point-of-care testing. This type of service has the potential to support the antimicrobial resistance agenda by reducing unnecessary antibiotic use and inappropriate antibiotic consumption.

Providers' knowledge and perceptions regarding antibiotic stewardship and antibiotic prescribing in rural primary care clinics

“…These roles will vary based on the pharmacist resources available in various outpatient settings such as community pharmacies, ambulatory care clinics, urgent care centers, and emergency departments. In the community pharmacy setting, pharmacists can assist patients in infection prevention through pharmacist‐administered vaccines, supportive care or symptomatic relief recommendations for common respiratory viral infections, patient education, antibiotic prescription reconciliation, allergy assessment interviews, and potentially for point‐of‐care testing to guide clinical decision making in appropriate antibiotic prescribing . Ambulatory care, urgent care, and emergency department settings may utilize pharmacist resources for additional initiatives as well including, but not limited to health care professional and patient education, allergy assessment interviews, collaborative practices for AS endeavors, and development of evidence‐based treatment algorithms for common outpatient infections in the electronic medical record to minimize antibiotic prescribing variation …”

Exploring views of pharmacists on antibacterial prescribing: a Maltese perspective

“…Analysing the outcomes of pharmacist prescribing in the United Kingdom has led to the realisation of the benefits that this practice brings along. Thornley et al . have shown that a community pharmacy‐based screening and treatment service, run by trained pharmacy staff, using point‐of‐care testing has the potential to reduce antibiotic pressure from patients and help in the effort to reduce the emergence of antibiotic resistance.…”

“…Analysing the outcomes of pharmacist prescribing in the United Kingdom has led to the realisation of the benefits that this practice brings along. Thornley et al [27] have shown that a community pharmacy-based screening and treatment service, run by trained pharmacy staff, using point-of-care testing has the potential to reduce antibiotic pressure from patients and help in the effort to reduce the emergence of antibiotic resistance. Having pharmacists as non-medical prescribers allows general practitioners to concentrate more on diagnosis and procedures, helps reduce drug expenditure and wastage, helps improve adherence to guidelines whilst reducing the risks of prescribing and communication errors, helps improve patient care through easier medication access and reduce waiting times for patient review.…”

Sore throat test and treat – a £34 million question?

“…As one of eight interventions chosen for the second year of the programme, the sore throat project is based on a non-NHS service piloted in 35 community pharmacies owned by Boots. People (aged 12 years or older) were assessed using Centor criteria and those identified as being at increased risk of a bacterial infection were offered a throat swab and rapid antigen test with the option of an antibiotic if the test was positive 3. Patients were charged for the cost of the service and the supply of antibiotic.…”