Management of acute upper respiratory infections during the COVID-19 pandemic: Challenges for community pharmacies

ABSTRACT

Background: During the COVID-19 pandemic, the accessibility of health services at community pharmacies for the management of minor ailments became even more relevant, particularly in the case of acute Upper Respiratory Infections (URI) for which symptoms are often similar. Purpose: To provide a clinical pharmacy service to assess and manage symptoms of acute URI and to reaffirm the role of community pharmacies, in these challenging times, as the first line of advice, treatment, and referral, preventing unnecessary visits to emergency rooms. Method: A literature review was carried out to define the appropriate pharmaceutical intervention to assist patients with symptoms of acute URI. Patients were identified by pharmacy teams based on the presence of symptoms suggestive of acute URI or when filling a prescription for an acute URI treatment. The service consisted of an initial assessment and two follow-up contacts (conducted either by phone or face-to-face) 2 and 10 days after initial assessment. A total of 110 pharmacies received training and educational resources to support the service, and surveys to collect data were designed for each contact. Patient registration, task scheduling and surveys were setup and made available through a computer application. Findings: From February 2020 to November 2021, a total of 2239 patients were enrolled in the programme, in 63 participating pharmacies. Most patient were between 31 and 70 years old (n = 1290;56.3%) and 1344 (60.0%) of them were female. At the initial assessment, the top 3 symptoms identified were runny or itchy nose, and sneezing (23.0%), sore throat (22.9%), unusual cough or worsening of the usual pattern (16.6%). At the initial assessment and during follow-up, the counseling of non-pharmacological measures to alleviate symptoms, along with other pharmaceutical interventions, mostly focused on increasing health literacy, were 3.5 times more frequent than the dispensing of over-the-counter medicines. In addition, there were 346 referrals to the physician. At first follow-up contact, 90.4% of patients reported feeling better, and at the second follow-up contact this percentage was 97.1%. A total of 215 medical consultations were reported by the patients, during follow-up contacts (127 by the first follow-up contact and 88 by the second). As result of these medical appointments, patients were diagnosed with COVID-19 (n = 16), other respiratory illnesses (n = 75), chronic disease decompensation (n = 7), or other diseases (n = 39). Conclusion: During this challenging context for the health care sector, pharmacists play an important role in managing minor ailments, supporting patients throughout their journey, and cooperating with other health care professionals.