Get pharmacists treating more UTIs and free up emergency rooms, study suggests

A new study conducted in New Brunswick has found that patients with uncomplicated urinary tract infections can be safely and quickly treated through pharmacists alone.

Given that urinary tract infections are among the top five reasons people end up in emergency rooms across Canada, the study's authors believe their finding could help unburden the country's health-care system.

The study has a long title: "Outcomes of Urinary Tract Infection Management by Pharmacists: A study of pharmacist prescribing and care in patients with uncomplicated urinary tract infections in the community."

The research is being published in the Canadian Pharmacists Journal and was officially released at the recent Canadian Pharmacists Conference in Fredericton.

Nearly half of women will have experienced a UTI by the time they reach their early 30s, making the condition a common problem, said Dr. Daniel Smyth, one of the authors of the study and an infectious disease specialist at the Moncton Hospital.

"So it's something that poses a significant burden for our health-care system," he said. "It leads to a lot of health-care resources, especially in acute care settings, in New Brunswick."

What we're trying to show here is that these uncomplicated infections can be safely managed outside of an acute care.- Alistair Bursey, Fredericton pharmacist

New Brunswick pharmacists have been able to prescribe for uncomplicated urinary tract infections since 2014, but the service is not funded by Medicare when it is provided by a pharmacist.

That means patients would pay for the visit with the pharmacist out of pocket.

Antibiotics are often prescribed for urinary tract infections, and patients might also require pain medication, according to the Mayo Clinic website.

Positive outcomes 

The New Brunswick study was conducted between June 2017 and April 2018 and involved 750 patients who went to pharmacies seeking help for symptoms of an uncomplicated urinary tract infection or had a new prescription from a physician for a urinary tract infection.

Pharmacists involved in the study performed patient assessments and either prescribed medication, provided education only, or referred patients to a physician if appropriate. 

At the two-week followup, 88.9 per cent of patients reported their symptoms had been resolved. The study also found that patients were, on average, able to access a pharmacist a day sooner than a physician.

Smyth said he thinks the study shows that if patients are able to access medication for a UTI from a pharmacist directly, the number of people ending up in emergency rooms could be reduced.

"The emergency room is the last place where someone with an uncomplicated urinary tract infection should present," Smyth said. 

"What we're trying to show here is that these uncomplicated infections can be safely managed outside of an acute care." 

Alistair Bursey, a pharmacist in Fredericton and past chair of the Canadian Pharmacist Association, said he thought the study was "groundbreaking" given how common UTIs are.

"There's not a day that goes by we don't fill a couple prescriptions at least for UTIs, and that's just one pharmacy," he said.

If patients don't have to wait in an emergency room to get access to those medications, "that frees up room for patients that really need to be in those emergency rooms," Bursey said.