An exploratory study of community pharmacist diagnosis and management of dermatitis and acne

Author

Rod P Tucker*, Katie MacLure*, Vibhu Paudyal*, Alison M Layton**, Anthony Bewley†, Derek Stewart*

Afilliations

*School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, AB10 7GJ, Scotland, UK **Harrogate & District NHS Foundation Trust, Department of Dermatology, Harrogate, England, UK †Whipps Cross University Hospital, Department of Dermatology, London, England, UK

Abstract

Background:

Dermatitis and acne account for a large number of general practitioner appointments yet are amenable to treatment with products available to purchase from community pharmacies.

Objectives:

1. The clinical appropriateness of community pharmacy interventions for these conditions
2. Patient reported measures of the effectiveness of the pharmacist’s management of their condition.

Methods:

Nine community pharmacies opportunistically recruited patients presenting with suspected cases of both conditions, taking digital images and audio-recording the consultation. These files were uploaded to a secure site and independently reviewed by three dermatology specialists.

Following their consultation, patients received a questionnaire to assess their views on the effectiveness of the treatment provided and their level of satisfaction with pharmacy management.

Results:

Forty patients (36 dermatitis and 4 acne) were recruited.

Of 113 assessments (7 not rated due to missing data) reviewed, specialists agreed with pharmacist’s diagnosis in 33.6% of cases, disagreed in 38.9% but were unable to determine the diagnosis in 27% of cases. Treatment was deemed appropriate in 42% of cases, inappropriate in 27% and indeterminate in 31% of cases.

Twenty-three patients (58%) returned a questionnaire and 12 of these (54.5%, 1 missing) stated that their condition had cleared completely following pharmacist advised treatment. Almost all (91.3%) were very satisfied or satisfied with the advice and/or treatment provided.

Conclusion:

Specialists judged the clinical appropriateness of pharmacist diagnosis and management as suboptimal yet patients were more positive. This study indicates a possible need for greater assessment-related training in dermatology for study pharmacists and further work to determine the generalisability of findings.

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