Could community pharmacies offer an opportunity to improve outcomes for patients with bowel cancer?

Lower bowel symptoms are common. A significant number of patients seek to treat their symptoms by purchasing over the counter medication.

To test the deployment of a self-administered questionnaire as an aid to advising patients with lower bowel symptoms.

Patients attending 21 community pharmacies were invited to complete the Patient Consultation Questionnaire (PCQ) before purchasing a medicinal product to treat their symptoms. Patients were invited to participate if they were: 1) presenting with lower bowel symptoms (rectal bleeding, constipation and/or diarrhoea); 2) 18 years of age or older; 3) able to provide informed consent; 4) not pregnant and had not been pregnant for the last three months. The PCQ was scored by a researcher and the results relayed to the patient and their general practitioner (GP) within a week. Patients were telephoned four weeks later to ascertain if they had consulted a medical practitioner.

Ninety-one patients were recruited. Most were female. As anticipated, the majority of patients presenting to pharmacies are at low risk of pathology compared to the population of patients referred by UK GPs for specialist investigations. Only eight patients were recommended to consult their GP because their PCQ scores suggested an appreciable risk of colorectal pathology. Five consulted a GP. Conclusions The scope to intervene in the pharmacy setting to promote intervention for significant bowel disease is suggested by the significant number of patients who would be advised to consult a GP using this intervention. These data support the case for a formal trial to test the value of the PCQ to signpost symptomatic patients to appropriate health care.