Evaluation of a community pharmacy service for uncomplicated urinary tract infection

Abstract

Introduction: Urinary tract infections (UTIs) are one of the most common conditions seen in female patients in general practice. Community pharmacy can supply antibiotics under minor ailment service patient group directions (PGDs) for a variety of indications, including uncomplicated UTI in women. The NHS Kernow Clinical Commissioning Group (CCG) funds such a locally commissioned minor ailment service. Aim: As part of an antimicrobial stewardship element of the General Practice Prescribing Quality Scheme for 2019–2020, the medicines optimisation team at NHS Kernow CCG, working with GP practices, community pharmacy and Pinnacle, performed a service review of the community pharmacy service for management of uncomplicated UTI in women. The objectives were to assess whether notifications of antibiotic supply were reliably received and recorded by GP practices, share learning of the evaluation with GPs and pharmacists, and develop actions to further improve the service. Methods: Women who received a community pharmacy supply of nitrofurantoin in July 2019 were identified from the PharmOutcomes platform and, where possible, the patient’s record in the GP system was reviewed. Results: In July 2019, the PharmOutcomes platform recorded 271 women who had received a supply of nitrofurantoin from a community pharmacy via the PGD. There were 239 supplies to women aged 16–64 years, and 32 supplies to those aged 65–75 years. All 271 women were recorded as receiving a Treat Antibiotics Responsibly, Guidance, Education, Tools toolkit and advice from the community pharmacy. Data from those surgeries in Cornwall (n=174 women) identified that 12% (n=21) were noted on the GP systems as requiring further antibiotic treatment for their UTI. Conclusion: This evaluation suggests that the service operated well from a community pharmacy perspective, although re-treatment levels may require further monitoring if possible. Increasing the quality of data recording in general practice with respect to such antibiotic use should be a high priority.