Referral of clients by community pharmacists in primary care consultations

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Abstract
In responding to symptoms presented by clients, community pharmacists have a number of options open to them, including giving advice to seek the assistance of another health professional (ie, a referral). The objective of this study was to investigate the referral patterns of community pharmacists in primary care consultations. The analysis was performed on 716 tape-recorded consultations between pharmacists and clients collected in a random sample of community pharmacies in London. Fifteen per cent of clients were referred to another practitioner, usually their general medical practitioner. Information on the cases that pharmacists referred is provided. There was a wide variation in referral rates depending on the nature of the presenting symptoms. Pharmacists' referral patterns tended to be determined by the characteristics of the symptoms presented. A situation in which some pharmacists routinely refer a high proportion of clients irrespective of the nature of the symptoms was not apparent. The symptoms referred by pharmacists may or may not be those which other primary health carers feel they should see. A co-ordinated, safe and appropriate role as a filter to other practitioners could contribute to improvements in the effectiveness and efficiency of primary care.