FEATURE: Get ready for winter

Will Pike argues how community pharmacists could help patients shift their mindset to think pharmacy first as the sector heads into a challenging winter…

Usually as we head into winter, we can all predict what our patients will be asking us about. But, just like the rest of the year has been like no other in community pharmacy, I’d expect this winter to be different too. This will present us with challenges, but also some great opportunities too.

One shift we have seen over the last seven months of Covid is that more and more people in the community are turning to their pharmacy for help, support and advice. With our doors remaining open throughout the height of the pandemic, we’ve established ourselves firmly at the heart of local healthcare – a trend I’d expect to see continue over the winter, especially now that a second wave, it seems, is upon us.

I think there’s three different types of patients who we’ll be seeing this winter coming to us for help and advice.

First, we’ll see those with a simple winter illness – for example, a common cold. For these patients our advice will be focused around self-care and home treatments. There is a wide range of products that we can recommend in the pharmacy from decongestants to combination products such as Night Nurse and nasal sprays.

This is a great opportunity to suggest the right Pharmacy Only Medicine for the patient, something they may not have considered before. But it’s not just about selling a medicine, we should also advise how the patient should keep themselves warm and well hydrated and advise them about multivitamins and supplements if we feel they may not be getting their requirements from their diet.

If they’re more vulnerable, then also checking that they have some support at home is also a good move. The NHS recommends 400iu of vitamin D over winter as deficiency in vitamin D is associated with increased autoimmunity as well as an increased susceptibility to infection.

Next up, we’ll see those who are perhaps suffering from more complex conditions including exacerbations of asthma or COPD. My advice here is to maintain great patient care by reinforcing the best inhaler technique and always recommend keeping a spare reliever inhaler in stock.

Each winter I direct patients to their GP for a rescue pack to keep in their medicine cabinet in case of severe exacerbations. I will be especially vigilant this winter as we want to keep our most vulnerable respiratory patients out of GP surgeries and the pharmacy if they get ill, so having the right tools at home for them is absolutely essential.

This in turn will help reduce hospital admissions this winter. As always we will be encouraging patients to stop smoking and offer a wide range of products in store to help people on this journey.

Then there are those who will need guiding to other services and support. We’re likely to see more of this as people perhaps avoid their GP – either through choice or necessity – and seek out some face-to-face advice. A specific challenge we’re going to face this year is around how some Covid symptoms are similar to those of the flu. Make sure all the team are aware and confident with what different symptoms mean – and keep abreast of any new developments in case new symptoms of Covid get added to the list.

Some patients may just need reassurance around what their symptoms mean, but I’d advise you know how to direct people to get tested and what self-isolation measures they should take if you suspect Covid.

It won’t have escaped anyone’s attention I’m sure the extra emphasis that the government are pushing on getting the flu jab this year. If this is something that you offer, then we must all play our part in helping achieve the levels of vaccination asked for this year.

But we must be responsible. We must explain that the flu vaccination won’t necessarily stop Covid, but it might provide a much-needed boost to the adaptive immune system and may enhance the immune response against a range of pathogens this winter.

However, given how the symptoms of flu and Covid are similar, if a patient has had the flu jab and then show flu-like symptoms, they’ll know to treat this more seriously and not shrug it off as a cold.

It’s also worth thinking about – where available – taking the time with flu jab patients to explain the benefits that a pneumococcal vaccination would also give. With such an emphasis on the flu jab, it’s easy for patients to not even think that there might be something else that can help them stay healthy over the winter.

So, while we may expect to be busier this winter, our core focus is the same – helping patients with their immediate medication needs, but also providing advice as a trusted healthcare professional on how they can prevent themselves from falling foul to winter illnesses in the first place.

And this winter, with the threat of a second wave of Covid seemingly never far away, we have a unique opportunity to encourage patients keep their medicine cabinets stocked up with common OTC products such as loperamide, decongestants, pain killers and linctus so they’re ready to fight whatever winter throws at them even if they have to self-isolate.

And finally, I’d recommend that you reassure your patients that their pharmacist is only a phone call away for advice, particularly if they should need to self-isolate. This is how we’ll help patients shift their mindset to think pharmacy first.

Will Pike is a pharmacist at a Well pharmacy branch in Wonford, Devon.

This feature also appears in the print edition of Pharmacy Business/Oct 2020.