Home' Australian Pharmacist : Australian Pharmacist April 2016 Contents Australian Pharmacist April 2016 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
Katie Hayes is an accredited consultant pharmacist
and the manager of the Risdon Vale pharmacy in
After reading this article, pharmacists should be
Identify and assess patients’ needs for
chloramphenicol eye drops
Explain how pharmacists can provide counselling,
including written counselling, to patients when
Describe how the PSA document on Guidance
for provision of a Pharmacist Only medicine –
chloramphenicol for ophthalmic use, can be
utilised by pharmacists.
Competencies addressed: 1.3, 1.4, 2.1, 6.1, 6.3,
7.1, 7.3 .
Accreditation number: CAP160404A
COUNSELLING IN PRACTICE
BY KATIE HAYES
Mrs EB, a lady in her 30s, tells you that she thinks she has conjunctivitis
and she is worried her three-year-old daughter may catch it.
Conjunctivitis, or inflammation of
the conjunctiva, is indicated by eye
erythema, irritation, itchiness and/or
discharge to varying extents.
It is most
commonly a result of bacterial or viral
It may also be caused by
allergy, or as a result of ocular irritation
such as from a foreign body, smoke or
Eye complaints, particularly infectious
conjunctivitis are a common reason for
patients seeking medical help,3 with a
2009 Australian survey indicating that
0.5% of patient conditions discussed
with their general practitioner were
for infectious conjunctivitis.
high prevalence of conjunctivitis, and
the accessibility of pharmacists, it is
important pharmacists have a thorough
knowledge of the differential diagnosis
of conjunctivitis, how to manage it,
and when to refer to other health
Pharmacist Only medicines
Pharmacists are responsible for the safe
and judicious provision of medicines
as indicated in the Professional Practice
Standards5 and this needs to be a
priority when supplying Pharmacist
Only medicines. Criterion 1 of Standard
12 in the Professional Practice Standards
specifically details the requirements for
provision of Pharmacist Only medicines.5
Standard 12 also indicates the need to
gather information to make an informed
decision on managing the patient’s
condition as well as ensuring that care is
tailored to the individual.
The PSA Guidance for provision
of a Pharmacist Only medicine –
chloramphenicol for ophthalmic use6
assists pharmacists to confirm patient
signs and symptoms and identify the
cause of the complaint.
It provides recommended steps to
ensure best practice.
should be remembered that the use
of this guidance document should
be individualised to each patient and
Privacy and documentation
A patient’s privacy and confidentiality
should be upheld at all times.
Consideration should be given to where
the interaction with the customer takes
place, e.g. should it be in a more private
area of the pharmacy. Documenting these
interactions can be useful, especially for
follow-up and referral. Consent should
be obtained from the patient before any
documentation is undertaken.
To ensure that diagnosis is correct and
therefore management is appropriate,
it is important to take a history of
the presenting complaint, including
symptoms and signs, and their duration,
as well as any co-existing symptoms.
The pharmacist also needs to take a
patient history, which will assist in
determination of appropriateness of
treatment, and whether referral to
another health professional is necessary.
Signs and symptoms
With the patient’s consent, examine the
eye by observation for signs such as
erythema, discharge, and swelling.
Questions to ask the patient include1:
Is there a discharge? Can you describe
Are there any changes to your vision?
Changes may include loss of vision,
darkening of vision or halos around
Is there eye pain? Can you describe
the pain? Where in the eye is the pain?
Is there redness and where is it?
How long have you had the
Are there any other symptoms such as
cough or cold symptoms, or nausea?
What (if any) actions have you taken to
manage the condition and what effect
did this have?
Bacterial conjunctivitis usually begins in
one eye causing a purulent discharge.
The infection may transfer to the other
eye in 1–2 days.
The discharge may
cause blurred vision which resolves
when discharge is removed, and it
may cause the eye to become glued
together overnight due to drying of the
discharge.2,6 The patient may experience
discomfort or pain in the form of stinging
and a gritty sensation.
Eye erythema is
generalised and diffuse.
Although somewhat difficult to
differentiate between bacterial and viral
conjunctivitis, viral conjunctivitis has a
watery discharge and is often associated
with upper respiratory tract infection.
Allergic conjunctivitis also has a watery
discharge, there is usually itching in
the eyes and there is often associated
symptoms such as rhinitis.
Patients presenting with any of the following
need to be referred to an ophthalmologist
or hospital immediately1,3,6,8
eye pain – differentiating from
discomfort at the surface of the
eye that occurs with infectious
loss of vision
Links Archive Australian Pharmacist March 2016 Australian Pharmacist May 2016 Navigation Previous Page Next Page