Patient-initiated consultations in community pharmacies.

Background: Mobilizing pharmacists practicing in community pharmacies as a new player in primary care has recently emerged as a cost-effective strategy for clinical consultations related to minor ailments. However, little is known about these consultations initiated by patients. The objectives of this study were to describe patient initiated consultations in community pharmacies, and to estimate the impact of these consultations on care-seeking behaviors of patients.

Methods: A cross sectional study was conducted in 11 retail pharmacies in Quebec, Canada, from October until December 2017, using two data sources: 1) an application and 2) structured interviews. Pharmacists had to compile all consultations in the app during a 4 week-period. Consenting patients were interviewed on the day of the consultation and one week after. Descriptive statistics on the number of consultations were calculated, as well as on the recommendation and the experience of the patient.

Results: A total number of 4994 consultations were entered in the app by 55 pharmacists, with an average of 18 consultations (SD = 7) per pharmacy per day. Of the 900 patients consented to participate to the study, 600 (67%) completed the two interviews. Pharmacists reported that they recommended another healthcare resource to patients (e.g. emergency department (ED), walk-in clinic) in only 15% of cases. In the week following the consultation, 105 (18%) patients reported that they avoided going to the ED as a result of the consultation. Patients in rural regions or consulting in a pharmacy far from a medical clinic were more likely to report avoiding an ED visit as a result of the consultation with the pharmacist.

Conclusions: This study suggests that patients are seeking advice from pharmacists for a variety of health care concerns and that pharmacists are able to manage most of these consultations, with a high level of patient satisfaction.