Impact of a pilot NHS-funded sore throat test and treat service in community pharmacies on provision and quality of patient care

Abstract

ObjectiveA National Health Service (NHS)-funded sore throat test and treat (STTT) service was introduced in selected pharmacies in two local health boards in Wales, as an extension to the national pharmacy common ailment scheme. The aim of this study was to evaluate the impact of STTT on provision and quality of patient care, namely antibiotic use, patient safety and general practitioner (GP) consultation rates.MethodsSecondary analyses of STTT consultation data to describe service outcomes, and routine data to explore changes in antibiotic prescribing and the prevalence of complications. Data were also collected from one GP practice to explore the feasibility of measuring changes in sore throat consultation rates in general practice.ResultsLess than 20% of 1725 consultations resulted in antibiotic supply. The availability of STTT was associated with greater reductions in prescriptions for phenoxymethylpenicillin than in areas where STTT was not available (−3.8% and −3.4%, difference 0.4%). When pharmacy supplies were included, the reductions in the supply of the antibiotic were similar. No increase in the monthly number of incidents of quinsy was detected, and patients were appropriately referred to other healthcare professionals during pharmacy consultations. GP consultation rates since introduction of STTT were found to be lower than the equivalent monthly average since 2014.ConclusionsData from the first 5 months of the STTT service suggest that it may have a role in safely rebalancing uncomplicated sore throat management from general practice to community pharmacies while continuing to promote antibiotic stewardship.

Understanding the impact of a new pharmacy sore throat test and treat service on patient experience: A survey study

“…A second study investigated data derived from a range of national databases providing pharmacy, GP, prescribing and secondary care data, to evaluate whether a pilot of an NHS funded pharmacy STTT service had an impact on antibiotic provision, patient safety and GP consultation rates. 11 No safety concerns were identified and findings suggested that STTT can be part of a collaborative approach aiming to re-balance uncomplicated sore throat management from general practice to community pharmacies whilst continuing to promote antibiotic stewardship. Data from all these 13 studies were triangulated and fed back to policy makers as part of an integrated approach to inform the service development.…”

“…The service adopted a staged test and treat strategy, with pharmacists using clinical scoring tools (FeverPAIN and CENTOR) to complete an initial examination, offering a POCT to screen for the presence of Streptococcus A if threshold scores were met, and antibiotics, if needed, in the case of a positive POCT. The model of service delivery has been described elsewhere, 11 and is also summarized in Supplementary Table 1. A study looking at the impact of the service on provision of patient care in the community setting suggested that STTT may have a role in safely re-balancing uncomplicated sore throat management from general practice to community pharmacies whilst continuing to promote antibiotic stewardship.…”

“…A study looking at the impact of the service on provision of patient care in the community setting suggested that STTT may have a role in safely re-balancing uncomplicated sore throat management from general practice to community pharmacies whilst continuing to promote antibiotic stewardship. 11 Another study evaluating pharmacists' perceptions of the STTT scheme revealed high levels of acceptability and satisfaction. 12 The aim of this study was to explore patient views of the STTT service using a methodology co-designed with patients as part of the research team.…”

Are We Making the Most of Community Pharmacies? Implementation of Antimicrobial Stewardship Measures in Community Pharmacies: A Narrative Review

“…For the purpose of the study, antibiotics could be supplied directly by the pharmacist under a Patient Group Direction. Follow-up was conducted on 51.9% of patients, of which 91.6% reported feeling better after using the service [ 55 ].…”

Structured review of primary interventions to reduce group A streptococcal infections, acute rheumatic fever and rheumatic heart disease

“…The study reported possible savings to the National Health Service (NHS) from the 41 general practitioner consultations avoided was among those patients at 2747 GBP in 2015 36 . An evaluation of a NHS sore throat test and treat service in Wales reported that the service was associated with a reduction in antibiotic prescriptions 37 . A United States study quantified the average amount of pharmacist time (25.3 min) required to complete a point‐of‐care test for a patient presenting with pharyngitis symptoms.…”