Patients with uncomplicated urinary tract infections can access effective and fast treatment from pharmacists, says a new study.
Released today at the Canadian Pharmacists Conference in Fredericton and published in the Canadian Pharmacists Journal, the peer-reviewed study is the first comprehensive evaluation of community pharmacist assessment and management, including prescribing, for uncomplicated urinary tract infections.
“This research told us clearly that pharmacist management of uncomplicated urinary tract infections is very effective and in high demand by patients,” says Dr. Ross Tsuyuki, Professor of Medicine in the Faculty of Medicine and Dentistry at the University of Alberta and one of the study’s authors. “Patients were also highly satisfied with the care their pharmacists provided.”
Urinary tract infections are among the top ten reasons for ambulatory clinic visits and in the top five reasons for emergency department visits in Canada. New Brunswick pharmacists have been able to prescribe for uncomplicated urinary tract infections since 2014, but the service is not funded by Medicare when it is provided by a pharmacist. In New Brunswick, patients must pay out of pocket to access pharmacist care for urinary tract infections. This fee was waived for study participants (and the pharmacies were reimbursed for this from the study budget) to remove that barrier and enhance study enrollment.
Conducted in New Brunswick between June 2017 and April 2018, the study enrolled 750 patients who presented to pharmacies to seek help for symptoms of an uncomplicated urinary tract infection or had a new prescription from a physician for a urinary tract infection. Thirty-nine New Brunswick pharmacies from across the province participated in the study. Pharmacists performed patient assessments for symptoms of a urinary tract infection and either prescribed antibacterial therapy, modified antibacterial therapy, provided education only, or referred to physician, as appropriate. Pharmacists screened all patients for signs of complication and referred them to a physician if those signs were present. At two-week follow-up, 88.9 per cent of patients reported their symptoms had resolved. The study also found that patients could access a pharmacist an average of one day faster compared to a physician.
“Pharmacists are accessible health care professionals who are very capable of taking on a larger role in the management of urinary tract infections,” says Dr. Nathan Beahm, Clinical Assistant Professor of Pharmacy at the University of Alberta and an author of the study. “Although an economic analysis will be forthcoming, it is not difficult to see that pharmacist management of this ailment will be a cost-effective measure, especially when comparing to the cost of an emergency department visit or a walk-in clinic visit.”
“This study has demonstrated that uncomplicated urinary tract infection can be safely managed in the community by pharmacists with improved access and high levels of patient satisfaction. It justifies an expanded scope of practice for our pharmacist colleagues in New Brunswick, especially for common clinical problems such as UTI that lead to high use of acute care facilities in our province,” says Dr. Daniel Smyth, an Infectious Diseases specialist physician at The Moncton Hospital and an author on this study.
Dr. Tsuyuki noted that the fee for this service is a barrier to many who seek help from their pharmacists for urinary tract infections.
“Public funding of this important service would likely improve access,” says Dr. Tsuyuki.
The study, Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP): A study of pharmacist prescribing and care in patients with uncomplicated urinary tract infections in the community, appears in the Canadian Pharmacists Journal and was authored by Nathan P. Beahm, BSP, PharmD; Daniel J. Smyth, MD, FRCPC; Ross T. Tsuyuki, BSc(Pharm), PharmD, MSc, FCSHP, FACC, FCAHS.
About the New Brunswick Pharmacists’ Association
The New Brunswick Pharmacists’ Association is the voice of pharmacists in the province and is committed to providing leadership for the profession and to improving the health of New Brunswickers. The not-for-profit Association represents the professional interests of over 830 pharmacists.
About the Canadian Pharmacists Journal
Established in 1868, the Canadian Pharmacists Journal (CPJ) is the oldest continuously published periodical in Canada. CPJ’s mission is to support pharmacists in optimizing patient care by linking knowledge to practice. CPJ is an official publication of the Canadian Pharmacists Association. CPhA advocates for pharmacists and supports its members to advance the profession and enhance patient outcomes.
For more information or to arrange an interview with the study’s authors, please contact:
New Brunswick Pharmacists’ Association