Referrals of dyspeptic self-care patients from pharmacies to physicians, supported by clinical guidelines

It is important that self-medication customers with potentially serious diseases are correctly referred from pharmacies to physicians. The aim of this study was to determine the appropriateness of pharmacy practitioners in referring customers suffering from dyspepsia to a general practitioner (GP).

Practitioners in 12 pharmacies, supported by clinical guidelines and training, recorded information regarding the dyspeptic customers they referred to a physician on a data collection card. The card was sent to a GP participating in the study, who did a regular medical history of the referred customer over the phone and assessed whether the referral was appropriate or not.

Out of 133 referred customers with dyspepsia, 132 completed the study. The GPs found that 119 (90%) needed a medical examination and/or prescription drugs and thus assessed these referrals as appropriate. In three cases (2%) the referral was doubtful and in ten cases (8%) not adequate, as the symptoms were more likely to come from an irritable bowel syndrome than dyspepsia.

The results confirm the role of pharmacy practitioners as important members of the primary health care team. Provided with the appropriate referral guidelines and training, they are in a position to operate as 'filters', promoting the adequate use of other primary care services.