Pharmacy-based evaluation and treatment of minor illnesses in a culturallydiverse pediatric clinic

Background: Among medically underserved immigrant parents, access to nonpre scription medicines for home treatment of minor childhood illnesses may be limited by scarce financial resources or language barriers. Objectives: To design and implement a new clinical service for an urban amb ulatory pediatric clinic with a large immigrant population that allows phar macists to evaluate and to treat children and adolescents aged 6 months to 19 years with minor acute illnesses and to provide bilingual patient educat ion materials. Methods: We developed protocols and encounter forms for pharmacist evaluati on of 5 pediatric conditions: cough/cold, fever, diaper rash, vomiting/diar rhea, and head lice. We published bilingual patient education materials for these conditions in 8 commonly spoken languages. We assessed safety by thr oughly reviewing the medical records of all patients who returned within 1 week of a pharmacy encounter and by asking parents in a telephone survey to compare services received through the pharmacy and the acute care clinic f or treatment of the common cold. Results: During the first year of this pilot program, 191 patients were eva luated and treated, 145 (76%) for cough/cold. Seventy percent of the patien ts were immigrants. No unexpected or adverse outcomes were detected, althou gh occasional deviations from established protocols were noted. Parent sati sfaction with the pharmacy sen-ice was high, and similar to that received t hrough the standard acute care clinic. Patients evaluated by pharmacists we re more likely to be attended to promptly (<15-minute wait) and were more l ikely to receive written information than patients evaluated by physicians for similar conditions. Conclusions: Pharmacist evaluation and treatment of minor pediatric illness es seems to be both safe and well accepted. Further studies are needed to e valuate the cost-effectiveness of this service in diverse settings. In stat es that allow pharmacists to have prescriptive authority, pharmacy-based ev aluation and treatment may improve access to care for children with minor i llnesses.