Mike Wakeman - Case Study - CRP in community pharmacy

1. Michael Wakeman BSc, MSc MRPharmS
Case Study
CRP in Community Pharmacy

2. The protein is made up of five sub-units arranged in a ring with beta sheets and alpha helices connected by
linking regions. CRP is a blood plasma protein produced by the liver. It is an acute phase protein, whose
levels rise in response to inflammation. It assists the binding of complement proteins to foreign or damaged
cells, an immunological response that destroys the target cells.
C-reactive Protein (CRP)

4. 6037
4530
50
Adults
Children/adolescents
Age unknown
more than 40% of study participants were children as from the age of 1 year
439
426
1852
820
200
608
Tonsillopharyngitis (children)
Acute sinusitis (adults)
Acute bronchitis (adults)
Acute bronchitis (children)
Chronic bronchitis
Common Cold
4345 patients in placebo-controlled clinical trials
Kaloba-Extensively Clinically
Investigated
16 4

5. Aims of Study
O Evaluate a CRP test in community pharmacy
O Assess the acceptability of point of care CRP
testing in community pharmacy
O Investigate any reduction in GP appointments
for non- LRTIs
O Assess impacts upon a subsequent antibiotic
prescribing.

6. Supporting Materials
O A brief introduction to CRP
O Cough/Chest Infection Poster A3
O Dear Doctor letter
O Dear patient letter
O FAQs
O PATIENT QUESTIONNAIRE
O Point of Care CRP testing Service Level Agreement
O Symptoms of a cold
O V4 TYI leaflet for community pharmacy
https://www.northstaffslpc.co.uk/point-of-care-testing-for-rti/

7. Creating Consumer Awareness

8. Patient pathway

10. Day 3 Follow-up
O Day 3 questions only:
O Were you expecting the test? (yes/no)
O Did the test help your understanding? (yes/no)
O Was it painful? (yes/no)
O Were the results easy to understand? (yes/no)
O Would you have otherwise have visited the GP?
(yes/no)
O Would you have otherwise have visited another
healthcare professional? (yes/no)
O Would you have expected antibiotics? (yes/no)
O Can I call back in 4 days? (yes/no)

11. Day 3 and 7 follow-up
O Day 3 and 7 questions:
O On a scale of 1–5 how would you assess the following symptoms:
O Shortness of breath (likert scale 1–5)
O Wheezing (likert scale 1–5)
O Chest pain (likert scale 1–5)
O Breathing abnormalities (likert scale 1–5)
O Perspiring (likert scale 1–5)
O Headache (likert scale 1–5)
O Myalgia (likert scale 1–5)
O Feeling generally unwell (likert scale 1–5)
O Others (please state)
O Do you have a fever (>38°C)? (yes/no)
O Have you subsequently needed to visit a GP or another healthcare
professional as a result of these symptoms? (yes/no)
O If yes, did you receive an antibiotic prescription? (yes/no)

12. Reports

21. Outcomes

22. Conclusions

23. https://www.pharmaceutical-journal.com/research/research-article/point-of-care-c-reactive-
protein-testing-in-community-pharmacy-to-deliver-appropriate-interventions-in-respiratory-tract-
infections/20204635.article

24. Supporting UK pharmacist study
O Evaluating a point-of-care C-reactive protein
test to support antibiotic prescribing decisions
in a general practice
O pharmaceutical-journal.com/research/research-article/evaluating-a-point-of-care-c-
reactive-protein-test-to-support-antibioticprescribing-decisions-in-a-general-
practice/20201688.article

27. Moving Forwards
O Extension of pilot study to embrace the whole
town of Cheadle
O 9 more community pharmacies commissioned
by NHS England to deliver POC CRP in
Staffordshire/Shropshire
O 2 community pharmacies delivering the service
in South and North of England
O Detailed impact of the intervention on
antibiotic prescribing

28. Thank You