None listed
Conditions
Brief summary
Ear disease is a major cause of preventable hearing loss and is very common in rural communities, estimated to affect 1.3 million Australians. Rural community pharmacists are well placed to provide improved ear health care to people who are unable to easily access a general practitioner (GP). The purpose of this study is to apply an ear health intervention to the rural community-pharmacy setting to improve the management of ear disease. Two rural community pharmacies will be recruited for the pilot study. Rural community pharmacists have been identified as highly qualified and easily accessible health professionals in rural and remote communities. They are often the first point of call for many people with minor ailments. Training pharmacists to perform otoscopy (visual examination of the ear canal and the eardrum with an otoscope), tympanometry (testing that measures the function and movement of the ear drum and middle ear) and generate appropriate referrals to general practitioners, may see patients receive ear health care in the most appropriate locations and result in economic savings by avoiding attending emergency departments unnecessarily. An ear health intervention in rural community pharmacy is anticipated to provide additional avenue for patients to access ear care which may result in ear complaints being managed in a more timely manner and thus a reduction in complications with associated financial and societal benefits. Utilising rural community pharmacists to provide an ear health program may improve health outcomes for rural and remote populations.
Interventions
This mixed-methods study is a pilot of a clinical intervention. The intervention will be piloted for 6 weeks at each pharmacy and then refinement and improvements will be made before the impact study is conducted for 12 months. Total duration of the intervention is 13.5months.
Advisory Panel
An advisory panel will be formed to provide expert advice on developing inclusion/exclusion criteria and indicators for referral. Experts in the field of ear health, general practice and pharmacy practice
This mixed-methods study is a pilot of a clinical intervention. The intervention will be piloted for 6 weeks at each pharmacy and then refinement and improvements will be made before the impact study is conducted for 12 months. Total duration of the intervention is 13.5months. Advisory Panel An advisory panel will be formed to provide expert advice on developing inclusion/exclusion criteria and indicators for referral. Experts in the field of ear health, general practice and pharmacy practice will be contacted via email with an invitation to participate in the advisory panel. Phase 1 – Enrolment of Participating Pharmacies, Pharmacists and General Practitioners Two pharmacies will be enrolled in the study. These two pharmacies have participated in earlier research and have expressed interest and capacity to participate in this project. Each pharmacy will be linked with at least one participating general practitioner. Phase 2 – Pharmacist Training Each participating pharmacist will undertake nationally credentialed training in otoscopy and tympanometry. This training is mixed mode with online and face-to-face components. Only pharmacists who have achieved the required training will be eligible to participate in the research. Completed certificates of training will need to be provided to the PI. Phase 3 – Pharmacy Preparation Each participating pharmacy will prepare their private consultation room to ensure privacy, and adequate personal protective equipment provisions (e.g. gloves, masks, sanitiser). Each participating pharmacy will prepare their computer to ensure capacity to generate and send immediate referrals appropriately. Pharmacy computers will be able to generate referrals electronically and print in paper form. Referrals to GPs will be sent via secure email at the time of the consultation with an appointment made for the patient via GP online booking system. The patient will also be provided a paper copy of the referral. Phase 4 – Service Delivery Participants will be recruited into the study when they present to a participating pharmacy with an ear complaint. If they meet the eligibility criteria and provide informed consent the pharmacist will perform a temperature measurement, otoscopic examination, tympanometry assessment and determine the appropriate treatment. Intervention may include no treatment, recommended treatment with products available in pharmacy without prescription (patient to pay cost of these products) or referral to GP (patient to pay cost of GP appointment). The patients will then be contacted 7 days later for follow up and either completion of the service or referral to GP. The expected duration of pharmacist assessment is 20 minutes.
Sponsors
Selina Taylor
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
13 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Members of the public attending a rural community pharmacy who are aged 13 or older. Adequate health literacy and English language to provide informed consent.
Exclusion criteria
<13 years of age Inadequate health literacy or English language to provide informed consent Obvious major trauma to the ear High COVID risk patient
Outcome results
None listed