The Case for Assessment and Treatment of Minor Ailments by Pharmacists
What is assessment and treatment of minor ailments?
Advantage to plan member
No wait time for quality care and treatment with personal follow-up by the pharmacist to ensure the effectiveness of treatment (a step rarely seen with standard physician care for minor ailments)
Advantage to employer
The employee was treated during their lunch break or non-work hours and immediate treatment means negative impact on productivity is reduced or eliminated
Advantage to plan
A condition is treated very quickly before it escalates and requires a more substantial healthcare investment
Minor ailments cover a gamut of conditions that include backache, coughs and colds, headaches and migraines, toothaches, indigestion, cold sores, rashes, allergies, and hay fever. By definition they are “common” or “uncomplicated conditions” that most patients can resolve with appropriate intervention; often with an assessment, guidance, and in some instances a prescription, from a pharmacist.
How can pharmacists help?
Encouraging employees to talk with a pharmacist as a first point of care for minor ailments offers measurable benefits to you the employer, your health plan, and above all, your employees. This is true for both your employees who have a regular doctor – and especially for those who don’t.
Pharmacists can provide employees who have a family physician with a more accessible, alternative treatment option. In 2012 the Ontario Pharmacists Association reported on a study conducted in the UK which revealed:1
- 93% of patients who accessed a minor ailment program (provided by pharmacists) liked the program because it provided them with a choice of location for treatment. .
- 88% liked the program because they could receive medical advice without attending the family physician’s office.
Case study example
Here’s one man’s story of how quick access to assessment and treatment for a minor ailment changed the outcome in a measureable way (names have been changed to protect privacy).
By providing the most accessible and fastest treatment options pharmacists can help reduce absenteeism and presenteeism, improve productivity, and lower the overall cost of an employer’s health plan.
When John, a middle-aged man living in Dartmouth, NS needed help with gastric reflux late one night, he turned to pharmacist, Ethan Hansen, BScPhm.
John met with his pharmacist who performed an assessment involving a combination of open-ended and close-ended questions that were appropriate to the situation. For example, “Are you currently taking any medications? Have you experienced these symptoms before? What medication has worked in the past?” After clarifying and reviewing what John shared, Ethan prescribed an over the counter (OTC) medication for his minor ailment within about 10 minutes.
Had Ethan’s pharmacy not been open that night, John would have had to wait until the next day to see his family doctor and receive treatment.
“He would have taken time off from work and possibly taken a full sick-day if his condition had not been quickly treated,” says Ethan – who also followed up by calling John the next day, and he sent a report to his family doctor.
The problem with traditional treatments for minor ailments
- Many treatments for minor ailments by doctors result in a prescription – leading to higher health plan costs when an OTC treatment would be effective
- When employees seek traditional treatment from a family doctor they usually take time from work – leading to higher absenteeism
- Lack of readily available physician care– due to hours of operation or location – or not having access to a family doctor delays some employees from seeking medical attention
Ethan Hansen’s Dartmouth pharmacy was part of a pilot project in Nova Scotia that examined how pharmacists could help patients by prescribing for minor ailments such as heartburn, diaper rash, insomnia, eczema, and cold sores.
“Patients really value this service and are very open,” says Ethan. “It also helps build stronger relationships with patients who then see us as more a part of their health care team.”
This simple case study illustrates the immediate and measurable way that pharmacists can address a range of health issues that can affect absenteeism, preesenteeism, and productivity while lowering health plan costs when they are the first point of care for minor ailments.
A similar pilot study involving 27 pharmacies from across Nova Scotia was conducted in the spring and summer of 2013 following new regulations that enabled pharmacists to offer patients a minor ailment assessment and prescribing service. Over 1,000 patients participated in the study. 96% of the patients who completed the satisfaction survey indicated that the service was beneficial or very beneficial, and 99% said they would use the service again. Patients particularly appreciated that the service was fast and convenient – and they valued the pharmacist’s knowledge and skills.2
The business case for plan sponsors
In a startling report by The Conference Board of Canada, the average absenteeism rate in 2011 was 9.3 days per full-time employee:
The direct cost of absenteeism to the Canadian economy was $16.6 billion in 2012.3
While absenteeism is a complex issue with many drivers, minor ailments are a major contributing factor. Workers are absent simply because they don’t feel well.
Sick at work
The lesser known cousin to absenteeism is presenteeism. This is a condition that occurs when employees are physically present yet distracted to the point of reduced productivity due to emotional or physical issues. They work slower or the quality of their work suffers or they make more mistakes leading to more workplace accidents.
Some studies suggest that the cost of presenteeism to business is much higher than absenteeism. According to a study by Cornel University, presenteeism “burdens” the U.S. economy with an annual cost of $150 billion dollars per year and an average of 6.5 working days of annual productivity lost per employee.4
Off to the doctor
Of course, for many employees, the traditional path is to schedule an appointment with their physician or wait in ER or a walk-in clinic. Typically these visits are scheduled during work hours, resulting in increased absenteeism and reduced productivity.
As well, a large proportion of primary medical conditions related to the treatment of minor ailments by family physicians results in a prescription treatment. This is a significant contributor to the high cost of drug plans in Canada today, as noted by the Patented Medicine Prices Review Board (PMPRB). According to PMPRB, prescription drug expenditures represent a significant component of health care costs in Canada with estimates of $27 billion spent in 2012.5
A growing number of Canadian don’t have a family doctor
Alarmingly, for a growing number of employees, seeking treatment from a family doctor is a luxury. According to research conducted by Statistics Canada in 2012, almost 15% of Canadians aged 12 and older, or roughly 4.4 million people, reported that they did not have a regular medical doctor.6 For employers and employees alike, pharmacists provide an alternate treatment option for minor ailments when no family doctor is available.
For all employees, accessing advice and treatment options from pharmacists for minor ailments reduces absenteeism. Employees:
- Don’t have to take time off work to seek treatment (as services are available through extended hours)
- Can access treatment options more quickly
Earlier intervention in any condition speeds recovery and helps reduce time away from work. Prompt intervention also reduces the possibility of complications of a more serious condition developing; requiring more expensive treatment options, additional time off work, or the possibility of short-term or long-term disability.
Potential for reduced drug plan costs
When pharmacists are the first point of contact, non-prescription or over the counter drugs (OTC) can, when appropriate, be a recommended, if not, preferred option over prescription medications as a first line of treatment.7 According to a 2012 study released by the Consumer Healthcare Products Association, the U.S. healthcare system saves $6 to $7 for every dollar Americans spend on OTC medications; translating into $102 billion in savings annually8 or about $10 billion in Canada.
Assessment and treatment of minor ailments in action
In all provinces the general process begins with a patient asking a pharmacist for advice about the treatment of a self-diagnosed condition.
The pharmacist confirms the diagnosis using a series of open and closed-ended questions and, if necessary, a physical exam. If the pharmacist can’t confirm the patient’s diagnosis and/or the symptoms are severe, they are referred to the appropriate healthcare provider for immediate treatment.
Usually over-the-counter products are available for a given condition. Once a therapeutic selection is made, the pharmacist demonstrates proper use of the product. The patient is provided with a timeline for when they can expect to feel better and what they can do to aid their recovery.
A follow-up appointment (by phone or in person) may be scheduled by the pharmacist. After any interaction with the patient, the pharmacist will provide 2 or 3 “monitoring points” which the patient can use to determine whether their condition is improving or further medical intervention is required.
A pharmacist first intervention for the treatment of minor ailments delivers important and measurable benefits to employees, employers, and health plans. In addition to helping reduce absenteeism through fast, accessible treatment, pharmacists can lead with cost effective OTC treatment options that can potentially lower drug plan costs.
1. OPA Value of Pharmacy Report 2012, Accenture, Understanding the value of expanded pharmacist authority in Ontario, 2012
2. Evaluation of the Provision of Minor Ailment Services in the Pharmacy Setting Pilot Study, Final Report, October 2013, prepared for the Pharmacy Association of Nova Scotia (PANS)
3. Missing in Action, Absenteeism Trends in Canadian Organizations, Conference Board of Canada, Briefing September 2013, compliments of Sun Life Financial
4. Mitrefinch, http://www.mitrefinchblog.ca/time-and-attendance/presenteeism-believed-to-cost-canadian-business-more-than-absenteeism/
5. Patented Medicine Prices Review Board, The Drivers of Prescription Drug Expenditures – A Methodological Report, December 2013
6. Statistics Canada, Canadian Community Health Survey, 2012
7. Since 2006 most provincial governments across Canada have expanded the prescribing rights of pharmacists.
8. Consumer Healthcare Products Association, The Value of OTC Medicine to the United States, January 2012