A study to assess the ability of community pharmacists to recognise and medically refer patients with a chronic cough has found that only a third of pharmacists provided appropriate medical referral.

The University of Western Australia study, published online this month in Annals of Pharmacotherapy, sent researchers to 155 Perth pharmacies, instructing them to present as patients with symptoms of chronic cough who required a referral.

When asked, the patients described the cough as dry, occurring mainly at night and present for "a couple of months or so".  In this scenario, the patient's cough was due to worsening asthma and they needed to be referred to a medical practitioner.

Researcher Carl Schneider, a PhD student under the supervision of Associate Professor Rhonda Clifford, from UWA's School of Biomedical, Biomolecular and Chemical Sciences, said community pharmacies were at the forefront of primary care providers and had an important role in the referral of patients to a medical practitioner for review when necessary.

"Chronic cough is a common disorder in the community, but it can be a sign of a more serious condition such as asthma or gastric reflux and it requires medical assessment.  Until we did this study we had no evidence of the proficiency of community pharmacy staff to refer patients with chronic cough," Mr Schneider said.

"Disappointingly, a large number of pharmacies (72 per cent) provided the patients with a cough suppressant, while advice to see the doctor was provided in less than half (38 per cent) of the visits.

"A medical referral was more likely when the patient was asked appropriate questions, such as medical history, and where a qualified pharmacist assessed the patient."

The researchers recommended the development of guidelines designed in partnership with medical practitioners and consumers to standardise practice.

"It is hoped that these guidelines will improve the rate of appropriate referral to medical practitioners and build closer ties with primary care providers to produce better outcomes for patients," Mr Schneider said.

The study is part of a larger project by researchers at UWA to improve the practice of community pharmacists in Western Australia and, as a result, improve patient care in the primary care setting.

Media references

Associate Professor Rhonda Clifford   (+61 8)  6488 3135  /  (+61 4) 07 894 247
(UWA School of Biomolecular, Biomedical and Chemical Sciences)
Simone Hewett (UWA Public Affairs)  (+61 8)  6488 7797  /  (+61 4) 13 444 154