Identification of patients attending accident and emergency who may be suitable for treatment by a pharmacist

Several studies have demonstrated that 25-40% of Accident & Emergency department attendances are for conditions that could be managed by the patient's general practitioner. The number of these who could be appropriately managed by a community pharmacist, has not previously been established.

To establish the frequency with which patients attend an inner city A&E department with problems that could be managed by a community pharmacist.

A cross-sectional, retrospective review of A&E records for adult patients (>16 years) was conducted during the first two weeks of March 1999. Application of recognised criteria identified patients whose conditions were suitable for treatment by a pharmacist. Associated patient characteristics were investigated.

During the study period 2636 adult patients attended the A&E department. Pharmacist management was considered appropriate in 8% of adult attendances (95% CI 6.8-8.9). The most commonly presented symptoms considered appropriate for pharmacist treatment included those of upper respiratory, gastrointestinal and pain conditions and reflect those previously identified in the literature.

A pharmacist could manage an estimated 8% of adult attendances at this A&E department. Efforts should be made to increase the awareness of the general public of the role of a community pharmacist to reduce demand on A&E and GP services.