Guest Blog 1 - Snorer Pharmacy

I’m really pleased to present my first Guest Blog here at www.pharmascholar.co.uk

The following piece, from ‘Snorer Pharmacy’, outlines how the Pharmacist is perfectly placed to support those within the community setting. Pharmacists can apply their professionalism, and now signpost accordingly, to help those patients who suffer with snoring issues that may impact upon their daily lives.

The Pharmacist's Developing Sleep Role

Snoring? “Hahah – who cares? I don’t hear it!”

Are you joking to cover your embarrassment?

Sadly, snoring is something that is often shrugged off and trivialised. But it is anything but trivial for those that cannot sleep because of the noise.

As a pharmacist have you ever wondered how to help? And what if your patient’s snoring is a symptom of obstructive sleep apnoea (OSA) syndrome – would you know how to recognise the warning signs?

While sales of OTC snore cures and gadgets with little if any evidence base encourage the unwary to self-diagnose and self-treat, the snorer with untreated sleep apnoea can expect to die 20 years sooner [1] than the average lifespan, independent of age, sex and BMI.

Sleep apnoea diagnosis and treatment is available from the NHS, and it could significantly extend their healthy life.

Screening and signposting are fulfilling roles for the community pharmacist and they support the healthy living and better care agenda [2].

What risk factors can be modified?

Excess weight and obesity are key moderators of the effect of OSA on T2DM [3]. 

As such, lifestyle and behaviour change advice that includes (where appropriate):

1. weight loss

2. alcohol reduction/cessation

3. increase in exercise

4. smoking cessation

is helpful [4] and something well-suited to the role of the community pharmacist.

As a sleep-trained pharmacist you will be able to advise snorers in a more informed way. Once trained, you will be able to recognise OSA symptoms that merit further investigation and connect patients to NICE recommended treatment, for both anti-social snoring and sleep apnoea.

You will be able to discuss evidence-based help that may extend their healthy life.

Further information may be located at: https://snorer.com/pharmacist/

References

1. Finn L, Young T. Sleep Disordered Breathing and Mortality: Eighteen-Year Follow-up of the Wisconsin Sleep Cohort. Yearb Pulm Dis. 2009;2009:291-292. doi:10.1016/s8756-3452(08)79181-3

2. Pharmacy in England: Building on Strengths - Delivering the Future - Great Britain. Department of Health https://www.gov.uk/government/publications/pharmacy-in-england-building-on-strengths-delivering-the-future 

3. Seetho IW, O’Brien S V., Hardy KJ, Wilding JPH. Obstructive sleep apnoea in diabetes-assessment and awareness. Br J Diabetes Vasc Dis. Published online 2014. doi:10.15277/bjdvd.2014.025

4. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365(9464):1046-1053. doi:10.1016/s0140-6736(05)71141-7

GP Referral to NHS Community Pharmacist Consultation Service (CPCS)

In a recent development to healthcare provision in England, the NHS Community Pharmacist Consultation Service (CPCS) is being broadened to now include referrals from GPs. The model will allow GPs to refer patients to community pharmacies for consultations for minor illnesses. Those pharmacy contractors who are registered to offer the CPCS service do not need to re-register to receive GP referrals because this is simply a development of the Advanced Service model (i.e. moving away from the pilot service paradigm).

Discussions between local providers of healthcare in England are essential in order to achieve effective service roll out. For example, GPs can decide if they would like to make CPCS referrals in the first place and if so then active dialogue between pharmacy outlets is a must.

A range of stakeholders will be involved in alignment decisions; for instance pharmacy contractors themselves, the respective Primary Care Network, the NHS, members of the local GP team plus the Local Pharmaceutical Committee (LPC). Clearly, as the support network for service delivery expands, more GP referrals should take place in the early parts of 2021 onwards.

The PSNC Director of NHS Services, Mr Alastair Buxton, commented:

“Enabling the GP referral pathway into the Community Pharmacist Consultation Service late last year was a strategically significant development of the service. Some general practices have already recognised its value and have worked with the NHS and LPCs to implement it locally, but the need for local implementation planning at a time when primary care is already very busy always meant there would be a phased adoption by general practices, rather than a big bang start.

We hope this short animation is a useful resource for LPCs and the NHS to use in engaging more practices and other stakeholders to support the rollout of the pathway.”

The short animation Mr Buxton refers to can be located here.

This appears to be an exciting development to support the delivery of excellent patient care in the heart of the community and as such we wish all those involved the best of luck at the beginning of 2021 and beyond.