The Pharmaceutical Journal Vol 263 No 7073 p843
November 27, 1999 News

Sunderland pharmacists deal with lice

Pharmacists in Sunderland are helping families deal with headlice infestations through a new headlice infection management service. Working with community pharmacists, local general medical practitioners and nurses have developed a service model that builds on work carried out in Nottingham last year and adopts current treatment methods. Under the Sunderland scheme, when customers approach participating pharmacies with concerns about headlice they are provided with a detection comb and a leaflet which explains how to comb headlice from the hair and which includes a small box. If suspected headlice are found, the customer has to bring one back to the pharmacy in the box for positive identification.

A particular role for pharmacists is establishing whether therapeutic failure is due to resistance or wrong use of medication

If lice have been found, then two 50ml bottles of Suleo-M lotion are provided for each infested person with instructions to apply the entire contents of a bottle, followed by the second bottle a week later. Patients who cannot use the alcoholic lotion because of skin problems are given Derbac-M instead. If the patient returns to report that treatment has failed, the pharmacist has to establish whether the treatment was used correctly. If it was not then the same treatment is provided again with further explanation. If the failure seems to be due to resistance, then treatment is repeated, this time using Full Marks lotion. If treatment fails again, then the therapy of third resort is carbaryl lotion, prescribed by a general medical practitioner.
Because the service is expected to be used mainly for children and people living in deprived areas, the lotions are provided without charge for people who are exempt from prescription charges. Participating pharmacists are paid a monthly fee by Sunderland health authority, which also pays for the lotions provided.
Pharmacists, nurses and doctors taking part in the service have been trained by the Medical Entomology Centre, Cambridge. Further training has been provided by a local GP, a nurse and the National Pharmaceutical Association's community pharmacy development co-ordinator for the north-east (Mr Matthew Shaw).
The service began in September and is funded by the health authority for 12 months. A preliminary evaluation of the scheme is to be conducted by Sunderland university after it has been running for six months.