Evaluating the management of urinary tract infections by community pharmacists in Queensland, Australia
Pharmacy Practice
Abstract
Background: While workloads of general practitioners (family physicians) can be supported by allied health professionals treating minor ailments, there is a need to evaluate the quality of these primary care interventions. In Queensland, Australia, appropriately trained community pharmacists provided empirical management of uncomplicated urinary tract infections to people with a biologic female urinary tract, between 18-65 years of age using a structured model of care. Objective: The aim was to determine whether community pharmacists can safely and effectively manage uncomplicated urinary tract infections. Methods: A prospective, observational, mixed-methods evaluation was designed to collect data over an 18-month period. People with a biologic female urinary tract, between the ages of 18-65 years, who presented to a community pharmacy, and met the symptom definition of an uncomplicated urinary tract infection, and agreed to participate in the study, were included. Results: A total of 10,270 instances of service provision were analysed. These services were recorded by 588 pharmacies that delivered at least one service. Follow-up data were available for 28.9% (2,973/10,270) services. Most (93.0%) were prescribed 3-days of trimethoprim as per the structured model of care and of those followed-up 87.6% reported resolution of symptoms following antibiotic treatment. For eighty five follow-up consultations (2.9%), patients indicated experiencing adverse events from antibiotic treatment. Five patients visited an emergency department, and upon review by doctors on the Steering Advisory Group, pharmacists were found to have followed the structured model of care in all cases. Conclusion: This study provides evidence that provision of antibiotics by appropriately trained pharmacists using a structured model of care was safe and effective. Given the rise in antimicrobial resistance worldwide, regular audits of prescribing by all health practitioners are recommended.
Keywords
- urinary tract infections
- health services accessibility
- primary health care
- clinical audit