The Pharmaceutical Journal
Vol 270 No 7233 p105
25 January 2003

This article
Reprint
Photocopy

News summary

Related websites
Family Practice abstract (more)

One in 12 patients in A&E departments could be managed by a pharmacist

Around one in 12 adults attending an accident and emergency department at a London hospital could have been successfully treated by a community pharmacist, new data suggest. These patients tended to be younger visitors to A&E.

The figure comes from a retrospective review of cases seen by the A&E department at St Thomas' hospital, London, over a two-week period. Out of 2,636 cases, community pharmacists could have managed at least 208 (8 per cent). This translates into 5,500 cases per year (Family Practice 2003;20:54).

Those suitable for management by a pharmacist tended to be younger than other A&E attendees or were more likely to be foreign visitors. "It may be that this reflects the itinerant daytime working population in the vicinity of the hospital or lack of understanding of the types of health care available in the UK," the researchers say.

They point out that A&E departments are keen to reduce inappropriate attendances and that this study helps quantify the potential advantages of encouraging patients to consider alternative sources of advice. "It may be that A&E departments should consider including a pharmacist within the triage process either to redirect patients to a more appropriate source or to deal with relevant problems at the time," they conclude.

The most commonly presented symptoms considered appropriate for pharmacist treatment included colds, coughs and sore throats, diarrhoea and vomiting, joint pain, minor wounds and blisters, contact dermatitis and skin allergies.

One of the study authors, Ruth Bednall, senior pharmacist, general medicine, Guy's and St Thomas' Hospital Trust, London, spoke to The Journal about the findings, which she thought might be reflected in other city hospitals.

She believes there is a role for pharmacists in A&E, particularly in view of Government targets to cut waiting times. Having a pharmacist to deal with low triage criteria may be one of the best ways forward, she said. However, she added that one problem would be convincing medical staff of the value of pharmacists despite the fact they treat this type of minor illness in the community.

Another issue was the grade of pharmacist who would be involved. "Senior pharmacists with a wealth of clinical experience do not traditionally work the shifts needed in a 24-hour service," Mrs Bednall noted.