Pharmacy-Based Evaluation and Treatment of Minor Illnesses in a Culturally Diverse Pediatric Clinic

Abstract

Background: Among medically underserved immigrant parents, access to nonprescription medicines for home treatment of minor childhood illnesses may be limited by scarce financial resources or language barriers. Objectives: To design and implement a new clinical service for an urban ambulatory pediatric clinic with a large immigrant population that allows pharmacists to evaluate and to treat children and adolescents aged 6 months to 19 years with minor acute illnesses and to provide bilingual patient education materials. Methods: We developed protocols and encounter forms for pharmacist evaluation of 5 pediatric conditions: cough/ cold, fever, diaper rash, vomiting/diarrhea, and head lice. We published bilingual patient education materials for these conditions in 8 commonly spoken languages. We assessed safety by throughly reviewing the medical records of all patients who returned within 1 week of a pharmacy encounter and by asking parents in a telephone survey to compare services received through the pharmacy and the acute care clinic for treatment of the common cold. Results: During the first year of this pilot program, 191 patients were evaluated and treated, 145 (76%) for cough/ cold. Seventy percent of the patients were immigrants. No unexpected or adverse outcomes were detected, although occasional deviations from established protocols were noted. Parent satisfaction with the pharmacy service was high, and similar to that received through the standard acute care clinic. Patients evaluated by pharmacists were more likely to be attended to promptly (Ͻ15minute wait) and were more likely to receive written information than patients evaluated by physicians for similar conditions. Conclusions: Pharmacist evaluation and treatment of minor pediatric illnesses seems to be both safe and well accepted. Further studies are needed to evaluate the costeffectiveness of this service in diverse settings. In states that allow pharmacists to have prescriptive authority, pharmacy-based evaluation and treatment may improve access to care for children with minor illnesses.

Parental attitudes towards head lice infestation in Greece

“…When it comes to treatment, parents often feel confident that they can control the infestation on their own, and they try to avoid visits to physicians in order to save time and money 12 . As a result, they seek advice from a physician only after the over‐the‐counter remedies have failed.…”

“…2,7,11 When it comes to treatment, parents often feel confident that they can control the infestation on their own, and they try to avoid visits to physicians in order to save time and money. 12 As a result, they seek advice from a physician only after the over-the-counter remedies have failed. Also, they sometimes feel confused, embarrassed, and stigmatized, due to the common misperception that head lice infestation is associated with poor hygiene and poverty.…”

Feasibility of Providing Interventions for Injection Drug Users in Pharmacy Settings: A Case Study among San Francisco Pharmacists

“…In Seattle, Washington, a pharmacist evaluated five pediatric conditions and provided bilingual patient education materials to an underserved immigrant population (Kalister et al 1999). Grabenstein at al.…”

The Feasibility of Pharmacy-Based Naloxone Distribution Interventions: A Qualitative Study With Injection Drug Users and Pharmacy Staff in Rhode Island

“…Current pharmacy-based health initiatives have focused on building pharmacies' capacity to serve as centers of community health (Haas et al, 2012;Kalister et al, 1999). Various chain pharmacies have implemented on-site clinics that provide primary health care services to their "patients" (Grabenstein, 1998;Mangum, Kraenow, & Narducci, 2003).…”