Background: Interventions to minimise antibiotic use have focused on the GP and patient behaviour rather than the community pharmacist (CP). While CPs often refer patients to GPs for assessment, there is limited research exploring CP referrals rates to GPs for suspected antibiotic-requiring infections.
Method: CPs and GPs were recruited independently using convenience sampling. CPs completed a prospective survey of 20 consecutive minor ailment encounters recording patient gender, age, referral reason and comments (if any). GPs also completed a prospective survey of 20 consecutive patient consultations, recording patient age, gender, reason for visit, and origin of patient referral including self-referral.
All data were analysed descriptively. Generalized estimating equations, multivariable logistic regression were used to investigate factors that may be associated with CP referral rates.
Results: Nineteen CPs representing 466 minor ailments, and 19 GPs representing 394 consultations were recruited.
CPs referred 16.5% (95%CI 12.2-21.1) of all minor ailments for a suspected antibiotic-requiring infection, referring most patients to a GP (80.5%, 72.7-88.9). Overall, CPs referred 37.1% (32.7-41.7) of minor ailments.
None of the consultations for infection in GP data were documented as being referred by a pharmacist; majority were self-referred (77.3%; 69.3-86.1). Only 4 pharmacist referrals were documented overall.
CPs were more likely to refer patients in remote areas (OR 2.8, 1.6-5.0) and those 2-12 years old (OR 2.8, 1.2-6.6) for a suspected antibiotic-requiring infection.
Discussion: CPs refer 1 in 6 minor ailment patients for suspected antibiotic-requiring infections; however, the appropriateness of these referrals is unknown. On the other hand, most GP consultations for infection were documented as self-referrals. Both provide potential points of intervention.
Implications for practice: Our data suggests new opportunities for CPs to help minimise unnecessary GP visits for infection; however, there is a need to explore the mismatch between CP referral rates and GP-reported referral source.