PT  - JOURNAL ARTICLE
AU  - Sarah Dineen-Griffin
AU  - Shalom I Benrimoj
AU  - Kris Rogers
AU  - Kylie A Williams
AU  - Victoria Garcia-Cardenas
TI  - Cluster randomised controlled trial evaluating the clinical and humanistic impact of a pharmacist-led minor ailment service
AID  - 10.1136/bmjqs-2019-010608
DP  - 2020 Nov 01
TA  - BMJ Quality & Safety
PG  - 921--931
VI  - 29
IP  - 11
4099  - http://qualitysafety.bmj.com/content/29/11/921.short
4100  - http://qualitysafety.bmj.com/content/29/11/921.full
SO  - BMJ Qual Saf2020 Nov 01; 29
AB  - Background Community pharmacists are well positioned to support patients’ minor ailments. The objective was to evaluate the clinical and humanistic impact of a minor ailment service (MAS) in community pharmacy compared with usual pharmacist care (UC).Methods A cluster randomised controlled trial was conducted. Intervention patients received MAS, which included a consultation with the pharmacist. MAS pharmacists were trained in clinical pathways and communication systems mutually agreed with general practitioners and received monthly support. Control patients received UC. All patients were followed up by telephone at 14 days. Clinical and humanistic impact were defined by primary (appropriate referral rate and appropriate non-prescription medicine rate) and secondary outcomes (clinical product-based intervention rate, referral adherence, symptom resolution, reconsultation and EuroQol EQ-5D visual analogue scale (VAS)).Results Patients (n=894) were recruited from 30 pharmacies and 82% (n=732) responded to follow-up. Patients receiving MAS were 1.5 times more likely to receive an appropriate referral (relative rate (RR)=1.51; 95% CI 1.07 to 2.11; p=0.018) and were five times more likely to adhere to referral, compared with UC (RR=5.08; 95%CI 2.02 to 12.79; p=0.001). MAS patients (94%) achieved symptom resolution or relief at follow-up, while this was 88% with UC (RR=1.06; 95% CI 1 to 1.13; p=0.035). MAS pharmacists were 1.2 times more likely to recommend an appropriate medicine (RR 1.20, 95% CI 1.1 to 1.3; p=0.000) and were 2.6 times more likely to perform a clinical product-based intervention (RR=2.62, 95% CI 1.28 to 5.38; p=0.009), compared with UC. MAS patients had a greater mean difference in VAS at follow-up (4.08; 95% CI 1.23 to 6.87; p=0.004). No difference in reconsultation was observed (RR=0.98; 95% CI 0.75 to 1.28; p=0.89).Conclusion The study demonstrates improved clinical and humanistic outcomes with MAS. National implementation is a means to manage minor ailments more effectively in the Australian health system.Trial registration number ACTRN12618000286246.