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Pharmacy-based evaluation and treatment of minor illnesses in a culturally diverse pediatric clinic
H Kalister1, R D Newman, L Read
1School of Pharmacy, University of Washington, and the Harborview Medical Center, Seattle 98118, USA.
Insights
Pharmacists can safely evaluate and treat minor pediatric illnesses, improving access to care for underserved immigrant families. This new service offers prompt attention and bilingual education, showing high parent satisfaction.
Area of Science:
- Pediatric Health
- Clinical Pharmacy Services
- Health Disparities
Background:
- Medically underserved immigrant parents face barriers accessing treatments for childhood illnesses.
- Limited financial resources and language barriers restrict home treatment options.
Purpose of the Study:
- To establish a clinical service in an urban pediatric clinic for pharmacists to treat minor acute illnesses in children and adolescents.
- To provide bilingual patient education materials to a diverse immigrant population.
Main Methods:
- Developed protocols for pharmacist evaluation of 5 common pediatric conditions.
- Created bilingual patient education materials in 8 languages.
- Assessed safety via medical record review and parent telephone surveys.
Main Results:
- 191 pediatric patients were evaluated and treated, primarily for cough/cold (76%).
- 70% of patients were immigrants; no adverse outcomes were detected.
- High parent satisfaction, prompt service (<15-min wait), and written information were reported.
Conclusions:
- Pharmacist-led evaluation and treatment of minor pediatric illnesses is safe and well-received.
- This service can enhance access to care, particularly for immigrant children.
- Further research on cost-effectiveness in various settings is recommended.
Background:
Among medically underserved immigrant parents, access to nonprescription medicines for home treatment of minor childhood illnesses may be limited by scarce financial resources or language barriers.
Objectives:
To design and implement a new clinical service for an urban ambulatory pediatric clinic with a large immigrant population that allows pharmacists to evaluate and to treat children and adolescents aged 6 months to 19 years with minor acute illnesses and to provide bilingual patient education materials.
Methods:
We developed protocols and encounter forms for pharmacist evaluation of 5 pediatric conditions: cough/cold, fever, diaper rash, vomiting/diarrhea, and head lice. We published bilingual patient education materials for these conditions in 8 commonly spoken languages. We assessed safety by thoroughly reviewing the medical records of all patients who returned within 1 week of a pharmacy encounter and by asking parents in a telephone survey to compare services received through the pharmacy and the acute care clinic for treatment of the common cold.
Results:
During the first year of this pilot program, 191 patients were evaluated and treated, 145 (76%) for cough/cold. Seventy percent of the patients were immigrants. No unexpected or adverse outcomes were detected, although occasional deviations from established protocols were noted. Parent satisfaction with the pharmacy service was high, and similar to that received through the standard acute care clinic. Patients evaluated by pharmacists were more likely to be attended to promptly (< 15-minute wait) and were more likely to receive written information than patients evaluated by physicians for similar conditions.
Conclusions:
Pharmacist evaluation and treatment of minor pediatric illnesses seems to be both safe and well accepted. Further studies are needed to evaluate the cost-effectiveness of this service in diverse settings. In states that allow pharmacists to have prescriptive authority, pharmacy-based evaluation and treatment may improve access to care for children with minor illnesses.
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