The Met-Office gave its three-month outlook for the months of April, May and June. It states a greater chance of above-average temperatures for these months. Many are predicting one of the hottest springs on record. Spring in all its glory, will bring with it flower buds, singing birds and blossoming trees. However, it will also see the return of sneezing, congestion, watery eyes, and all the other symptoms associated with seasonal allergies.
Allergies and their prevalence
The European Academy of Allergy and Clinical Immunology (EAACI) states that allergies are the most common chronic disease in Europe. To put things into perspective, more than 150 million Europeans suffer from chronic allergy conditions. The current prediction is that by 2025 half of the entire EU population will be affected. Allergic rhinitis (hay fever) can affect up to 30% of all adults. In the UK, allergic diseases cost the NHS an estimated £900 million a year. This represents 10% of the GP prescribing budget. But have you considered the different ways your pharmacy team can help in having a greater influence to these patients, and the growing number of patients being affected by allergies each year.
What causes seasonal allergies?
An allergy is your body’s immune system reacting to otherwise harmless substances, called allergens. The most common allergens, which are responsible for seasonal allergies include: grass, tree pollen, mould, dust mites, and animal dander. When an individual comes into contact with an allergen, the body’s defence system reacts in a certain way. When the allergen comes into contact with your antibodies, local chemical mediators called histamine are released. Histamine is one of the chemicals responsible for the different symptoms seen in seasonal allergies. It can cause skin tissue to become itchy and inflamed. Record-breaking temperatures coupled with high pollen counts will mean the return of all the symptoms of hay fever.
Go over-the-counter instead of on prescription
The most common symptoms for hay fever and seasonal allergies, include sneezing, nasal congestion, a runny nose, and watery eyes. Over-the-counter medicines can treat the majority of these symptoms. Greater advertisement showing the difference in costs between prescription based and over-the-counter medicines is a good thing. It shows that patients can alleviate the symptoms of hay fever for less money. This is something that will benefit your patients plus the NHS and its goal to increase self-care for patients.
The Stay Well Pharmacy campaign urges patients to first consider consulting the pharmacy team for help and advice relating to minor ailments, instead of GPs or A&E. It’s a nationwide campaign drawing on the clinical expertise of pharmacists, and helping relieve the burden on other NHS services. From the 1st April 2019, the prescription charge per item will be £9.00. Most of the simple remedies that offer symptomatic treatment of allergies can be bought for a lot cheaper over-the-counter. Promoting these over-the-counter products can help make your pharmacy as the first port of call for patients with allergy concerns.
Oral Antihistamines:
Antihistamines help relieve many of the symptoms related to hay fever and seasonal allergies. They are especially useful in relieving sneezing, itching, a runny nose, and watery eyes. Examples include Cetirizine, Loratidine, Chlorphenamine, and Promethazine. Antihistamines are also available in different formulations, which is great if the allergy affects a particular organ or tissue.
Decongestants:
Decongestants come in various formulations also, and are especially useful in relieving symptoms of nasal congestion and hay fever.
Corticosteroids:
These help relieve swelling and inflammation, and can be used in relieving the symptoms of allergic reactions. Steroid creams are available for purchase over-the-counter if the allergy isn’t relating to the face. These creams are for other parts of the body, especially the skin.
Adrenaline Auto-Injectors (AAI):
Schools in England are now able to purchase AAI devices without a prescription. AAIs are for emergency use on children at risk of anaphylaxis but whose own pen may not be working. Consider organising training for local schools on how to spot the signs of anaphylaxis and how to deal with them. You can also raise awareness of the guidance for purchasing emergency adrenaline auto-injectors and how to go about buying them. Further support with an example of a template letter that schools can provide is available on https://www.sparepensinschools.uk/
The Minor Ailment Service
The Minor Ailment Service is a locally commissioned service offering patients advice and support on the management of minor ailments. The pharmacist can also provide drugs, if necessary, for the treatment of the minor ailment. This avoids the need for those people to otherwise go to the GP for a prescription. Hay fever is also amongst the different ailments on the list for locally commissioned minor ailment schemes.
Have you considered delivering a presentation on the minor ailment scheme perhaps to the nearby GP practices? Promoting this service is another means to alleviating patients’ concerns relating to seasonal allergies. Here’s an example of a presentation that I delivered as a pre-registration pharmacist a few years ago, most of the information is still applicable today, the presentation increased the number of patients using the service, and it was especially useful for surgery staff in referring patients back to the pharmacy for advice and guidance.
Train your pharmacy team
Training your pharmacy team and keeping them up-to-date with knowledge relating to seasonal allergies is of paramount importance. Discuss with them the different ways that they could offer simple lifestyle advice in alleviating symptoms of allergies. These include keeping the home clean and using special bedding during months with high pollen counts. Other simple measures include having a shower after coming back indoors or changing bed covers regularly. Even easy steps like closing the bedroom windows at night can have an effect. Another great tool to inform both your staff and patients about is the Met Office App. This app will show when pollen count is likely to be high.
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This article was written on behalf of Mediapharm by Hassan Riaz from Pharmacy Mentor.