Preventing and Managing Urinary Tract Infections: Enhancing the Role of Community Pharmacists-A Mixed Methods Study

Nathan Peiffer-Smadja; Rosalie Allison; Leah F Jones; Alison Holmes; Parvesh Patel; Donna M Lecky; Raheelah Ahmad; Cliodna A M McNulty

doi:10.3390/antibiotics9090583

Preventing and Managing Urinary Tract Infections: Enhancing the Role of Community Pharmacists-A Mixed Methods Study

Antibiotics (Basel). 2020 Sep 7;9(9):583. doi: 10.3390/antibiotics9090583.

Authors

Nathan Peiffer-Smadja^{1

2

3}, Rosalie Allison⁴, Leah F Jones⁴, Alison Holmes¹, Parvesh Patel⁵, Donna M Lecky⁴, Raheelah Ahmad^{1

6}, Cliodna A M McNulty⁴

Affiliations

¹ National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Faculty of Medicine, Imperial College London, The Hammersmith Hospital, Commonwealth Building, Du Cane Road, London W12 0NN, UK.
² IAME, Université de Paris, INSERM, F-75018 Paris, France.
³ Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, F-75018 Paris, France.
⁴ Primary Care and Interventions Unit, Public Health England, Gloucester GL1 1DQ, UK.
⁵ Local Pharmaceutical Committee, Newham, London E7 8BA, UK.
⁶ School of Health Sciences, City University of London, Northampton Square, London EC1V 0HB, UK.

Abstract

Background: Community pharmacists are involved in antimicrobial stewardship through self-care advice and delivering medications for uncomplicated infections.

Objectives: This mixed methods study aimed to identify opportunities to enhance the role of community pharmacists in the management of service users with suspected or confirmed urinary tract infection (UTI).

Methods: Data collection was through a service user survey (n = 51) and pharmacist surveys and semi-structured interviews before (16 interviews, 22 questionnaires) and after (15 interviews, 16 questionnaires) trialing UTI leaflets designed to be shared with service users. Data were analysed inductively using thematic analysis and descriptive tabulation of quantitative data.

Results: Twenty-five percent (n = 13/51) of service users with urinary symptoms sought help from a pharmacist first and 65% (n = 33/51) were comfortable discussing their urinary symptoms with a pharmacist in a private space. Community pharmacists were confident as the first professional contact for service users with uncomplicated UTI (n = 13/16, 81%), but indicated the lack of a specific patient referral pathway (n = 16/16, 100%), the need for additional funding and staff (n = 10/16, 62%), and the importance of developing prescription options for pharmacists (5/16, 31%). All community pharmacists reported playing a daily role in controlling antimicrobial resistance by educating service users about viral and bacterial infections and promoting a healthy lifestyle. Enhancing their role will need greater integrated working with general practices and more prescribers based in community pharmacy.

Conclusion: This study suggests that community pharmacists could play a greater role in the management of uncomplicated UTI. The current reconfiguration of primary care in England with primary care networks and integrated care systems could provide a real opportunity for this collaborative working with potential learning for international initiatives.

Keywords: community; general public; leaflet; pharmacist; self-care; urinary tract infections.

Grants and funding

X/The research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London in partnership with Public Health England (PHE),