The Met-Office gave its three-month outlook for the months of April, May and June. It states the greater likelihood of above-average temperatures for these months, with many under the impression that it could well be one of the hottest springs on record. Spring in all its glory, will bring with it flower buds, singing birds and blossoming trees, but 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 and the current prediction is that by 2025 half of the entire EU population will be affected. Allergic rhinitis (hayfever) can affect up to 30% of all adults. In the UK, allergic diseases cost the NHS an estimated £900 million a year, representing 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, and causes skin tissue to become itchy and inflamed. Record-breaking temperatures coupled with high pollen counts will mean the return of all the symptoms of hayfever.
Go over-the-counter instead of on prescription
The most common symptoms for hayfever and seasonal allergies, include sneezing, nasal congestion, a runny nose, and watery eyes. The majority of these symptoms can be treated for by over-the-counter medicines. Greater advertisement showing the difference in costs between prescription based and over-the-counter medicines helping alleviate the symptoms of hayfever, is something which won’t just benefit your patients, but also the NHS in 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 hayfever 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 a particular organ or tissue is affected by the allergy.
Decongestants: Decongestants come in various formulations also, and are especially useful in relieving symptoms of nasal congestion and hayfever.
Corticosteroids: These help relieve swelling and inflammation, and can be used in relieving the symptoms of allergic reactions. Steroid creams can even be purchased over-the-counter if the allergy isn’t relating to the face, and another part of the body is affected, especially the skin.
Adrenaline Auto-Injectors (AAI): Schools in England are now able to purchase AAI devices without a prescription, for emergency use on children who are at risk of an anaphylaxis but whose own pen may not be working. It may be worthwhile organising training and guidance to local schools on how to spot the signs of anaphylaxis and how to deal with them, whilst also making them aware of the guidance relating to purchasing emergency adrenaline auto-injectors and how to go about it. 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 whereby patients are offered advice and support on the management of minor ailments. The pharmacist can also provide medication, if necessary, for the treatment of the minor ailment, for those people who would have otherwise gone to the GP for a prescription. Hayfever is also amongst the different ailments listed under 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. Also simple measures such as having a shower after coming back indoors, changing bed covers regularly and even simple steps like closing the bedroom windows at night. Another great tool you could inform both your staff and patients about, is the Met Office App, which shows 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.