Clinical outcomes following acute sore throat assessment at community pharmacy versus general practice: a retrospective, longitudinal, data linkage study

Mantzourani, Efi ORCID: https://orcid.org/0000-0002-6313-1409, Ahmed, Haroon ORCID: https://orcid.org/0000-0002-0634-8548, Bethel, Jackie, Turner, Samantha, Akbari, Ashley, Evans, Andrew, Prettyjohns, Matthew, John, Gareth, Gunnarsson, Ronny and Cannings-John, Rebecca ORCID: https://orcid.org/0000-0001-5235-6517 2024. Clinical outcomes following acute sore throat assessment at community pharmacy versus general practice: a retrospective, longitudinal, data linkage study. Journal of Antimicrobial Chemotherapy 10.1093/jac/dkae400

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Abstract

Background To date, no research has compared longer-term outcomes (antibiotic provision; re-consultations; hospital admissions for quinsy; cost-effectiveness) following presentation with acute sore throat at general practice (GP) versus newer, pharmacy-led services. Methods A retrospective, longitudinal cohort study of sore throat consultations between 1 November 2018 and 28 February 2020 either with the Wales pharmacy-led sore throat test and treat (STTT) service or with a healthcare professional at GP. Individual-level pharmacy consultation data from the national Choose Pharmacy IT application were securely uploaded to the Secure Anonymised Information Linkage Databank and linked to routinely collected, anonymized, population-scale, individual-level, anonymized health and administrative data. Results Of 72 736 index consultations, 6495 (8.9%) were with STTT and 66 241 (91.1%) with GP. Antibiotic provision at the index consultation was 1382 (21%) with STTT and 25 506 (39%) with GP [adjusted odds ratio (AOR), 0.30; 95% CI, 0.27 to 0.32]. Antibiotic provision within 28 days of index occurred in 1820 (28%) STTT and 26 369 (40%) GP consultations (AOR, 0.44; 95% CI, 0.41 to 0.47). GP re-consultation rate within 28 days of index date was 21% (n = 1389) with STTT compared with 7.4% (n = 4916) with GP (AOR, 3.8; 95% CI, 3.5 to 4.1). Coding limitations may lead to overestimates of GP re-consultations rates in the STTT group. Hospital admissions for quinsy were rare in both STTT (n = 20, 0.31%) and GP (n = 274, 0.41%) (AOR, 0.68; 95% CI, 0.43 to 1.1). STTT was less costly than consultation with GP. Conclusions The pharmacy-led STTT service is safe, cost-effective, and contributes to antimicrobial stewardship.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Medicine Pharmacy
Publisher:	Oxford University Press
ISSN:	0305-7453
Date of First Compliant Deposit:	18 November 2024
Date of Acceptance:	21 October 2024
Last Modified:	09 Dec 2024 16:31
URI:	https://orca.cardiff.ac.uk/id/eprint/174063

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