Urinary tract infection screening and referral service from community pharmacy

Introduction: Urinary tract infections (UTI), are a frequent health problem especially in women, with Escherichia coli as the main causative agent. Community pharmacy (CP) has proven to be a key resource in the detection and management of various infections, facilitating access to screening services and health counseling. Objectives: To design and assess the impact of a pharmacist-led professional service for the detection of suspected UTI in the CP setting, exploring its implementation in routine practice, patient follow-up, and referral to primary care when required. Methodology: A type 1 hybrid study was conducted involving 32 CP in Gipuzkoa. The CP offered the service to any person who entered the pharmacy with symptoms compatible with UTI, where a questionnaire and a urine test strip were administered. If the result of the strip was positive, the person was referred to the health care. In all cases, and depending on the pharmacist's criteria, non-pharmacological treatment was indicated and/or sanitary and hygiene measures were recommended and the patient was contacted after 3-7 days to follow up the problem. Results: A total of 272 individuals with UTI symptoms were recruited. 67.6% (n=184) of the patients had a positive urine test strip result and were referred to the health center, while 32.4% (n=88) had a negative result and received follow-up. Overall, the health problem was resolved in 60.6% (n=117) of the referred cases, and 58.2% (n=46) of those with a negative strip improved with pharmacist recommendations. Conclusions: The service enabled the identification and referral of patients with suspected UTI and supported the management of a relevant proportion of cases without medical referral. Pharmacist intervention and follow-up contributed to the structured management of mild urinary symptoms in the CP setting.