The Nature, Extent and Impact of Triage Provided By Community Pharmacy in Victoria
|Chief Investigator:||Professor Colin Chapman|
It is commonly known amongst the pharmacy profession that Australian community pharmacies are regularly approached by customers for advice about how to manage symptoms or other health issues. Some customers are subsequently referred to other health care providers. This process is sometime called triage whereby there is the sorting and prioritising of non-emergency customers for treatment, and is a process which seems to have gone largely unrecognised in recent times. Since new triage services are emerging in the form of telephone triage in many countries and as retail-based health clinics in the USA and now Australia, there is a need to better understand the current role of community pharmacies as an established triage service.
Experienced pharmacists were placed as observers in 24 Victorian community pharmacies in early 2009. Up to 20 customers who visited for health-related reasons were recruited from each pharmacy, resulting in 424 participants. Information was collected about each pharmacy and each observed primary health care event. Each customer was subsequently telephoned to determine the outcome of any advice received at the pharmacy.
There are several key findings:
(1) community pharmacies are regularly used by customers for advice about health issues but this is not the dominant health-related activity: most visits are to simply purchase medicinal products; (2) a wide range of health issues is addressed, with skin disorders and ear, nose and throat conditions dominating; (3) many visits are made by customers on behalf of others; (4) community pharmacies are not seen to be an alternative to GPs for serious health issues; (5) most customers only expect minor ailments to be dealt with through pharmacies; (6) most primary health care transactions are initially handled by pharmacy counter assistants: (7) most pharmacists are capable of providing primary health care, including triage, for a wide range of common ailments, not just minor ones; (8) customers were very satisfied with the level of service provided; (9) community pharmacies appear to be missing opportunities to play a much more central role providing primary health care; (10) the place of community pharmacies in the provision of primary health care seems to have diminished in recent times; (11) the consultation processes in most community pharmacies is incomplete, particularly in relation to recording, referral and return visits.
There is certainly scope for community pharmacies to play a much more extensive role in the provision of primary health care in the future.