A national pilot community pharmacy–led urinary tract infection service: clinical and patient-reported outcomes from 9077 consultations

Abstract

Background A national community pharmacy urinary tract infection (UTI) service was piloted in Wales between June 2024 and February 2025. The aim of this study was to understand the utility of the service for patients and its broader impact on primary care. Methods We conducted a retrospective, cross-sectional, descriptive study using anonymized individual-level data from all UTI service pharmacy records between 17 June 2024 and 31 January 2025. Patient-reported outcome measures were collected through follow-up phone calls. Results A total of 9077 consultations were recorded during the study period. In total, 8813 women (mean age 39.8 years) accessed the service. Pharmacists assessed and managed (with advice with or without treatment) 7621 (84%) consultations without need for onward referral. Antibiotics were supplied in 78.7% of consultations (n = 7143). Only 1% of consultations were considered to have resulted in inappropriate antibiotic supply, where pharmacists deviated from the structured treatment protocol. In total, 1006 consultations (11.1%) took place out of hours or at weekends. Of 2138 women responding to follow-up (23.6% of total), 87.0% (n = 1861) reported symptom resolution, and 14.4% (n = 301) reported contacting another healthcare professional after their pharmacy consultation. Of these 301, 62.7% (n=189) were supplied antibiotics. Conclusions Community pharmacists provided an accessible and effective UTI service, aligned with national diagnostic guidelines, and with antibiotic supply rates comparable to general medical practice. A pharmacy-provided treatment pathway, including urinalysis, may enhance UTI care by offering appropriate diagnosis and treatment that is widely accessible, reducing demand on general medical practice and without compromising antimicrobial stewardship.