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Analysis of a group A streptococcus (strep A) swab test service in community pharmacy for acute sore throat in adults (ID 434)
Reckitt UK
Funding: None
Abstract
AimResearches (Llor and Bjerrum, 2014; Mistry et al., 2020; Sur and Pelsa, 2022) have shown improper empirical therapy for sore throat management leading to growing antibiotic resistance concerns. To help improve guidance for clinical decisions and explore community pharmacists’ role in tackling antibiotic misuse, Reckitt provided swab tests to Superdrug for screening sore throat sufferers to examine their need for antibiotics.
Method
Pharmacists screened participants using FeverPAIN (FP) criteria but excluded those with FP scores <4. High FP scores (4-5) patients were tested with OSOMTM strep A swab tests, and if positive, it led to GP referral. The pharmacist advised strep A negative patients to take OTC medication and consult their GP for unchanged/progressive symptoms after 7 days. The pharmacist referred patients requiring medical attention to GP.
Results
86% (18/21) of high FP patients who tested negative for strep A were directed to OTC self-care. 34 out of 59 participants opted for GP service, but only 11 required appointments .A swab test for sore throat in pharmacies alongside trained pharmacy team to encourage patients towards appropriate self-care, helps reduces unnecessary antibiotics prescriptions. This led to 23 patients not visiting the GP. The potential annual cost-savings to the NHS was estimated as £509m.
Conclusion
Strep A rapid test on sore throat is not recommended by NICE. However, this study provides evidence that the service helps direct patients towards appropriate self-care treatment before GP intervention and provides additional guidance in clinical decision-making to minimise the uncertainty of reducing antibiotic prescription. GPs will save time on patients deserving more attention. It eases NHS pressure and empowers pharmacists to advise or refer appropriate patients.
Conflicts of interest: Attar-Zadeh D has received honoria from these companies for respiratory related work: Astra Zeneca, Boehringer Ingelheim (BI), Chiesi, Cipla, Glenmark, Glaxo Smith Kline, Johnson & Johnson, Napp, Novartis, Orion, Pfizer, Reckitt, Sanofi, Teva, Trudell
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