Giving patients the best advice

Patients need to ask for advice on sensitive topics, rather than self-diagnosing online and jumping to conclusions. What can be done to help reassure people? 

In the midst of excess pressures on health services such as A&E this winter, it seems that many other people are opting to ignore health issues and are not seeking advice about symptoms that worry them. In a recent survey, 40 per cent of people admitted putting off a GP visit, according to information quality watchdog The Information Standard. One-third were told they should have presented earlier.

Many people are self-diagnosing instead with the help of ‘Dr Google’, particularly for problems that are more embarrassing to discuss. Over half of people in the survey had turned to the internet – where it can be difficult for people to identify the reliability of information.

Dr Louise Newson, speaking for The Information Standard – the certification programme for organisations producing information for the public commissioned by NHS England – said that the health implications of poor information online ‘can be serious.’

Right place, right time

Encouraging people to seek evidence-based advice at the right time from the right places, such as community pharmacy, is a priority. And the online reach of pharmacy is developing.

Lloydspharmacy Online is one such service. The online prescription service has treated more than 600,000 patients already, around 85 per cent with sexual health problems such as erectile dysfunction, premature ejaculation and emergency contraception.

A spokesperson tells P3: ‘We provide health advice and treatment for patients who might otherwise be put off – or even avoid – seeing a doctor. Patients can also get advice and treatment for hair loss, eczema and more. All patients must complete an online consultation with one of our doctors, and our service is regulated by the Care Quality Commission. This is a far safer and more effective alternative to patients self-diagnosing by searching for symptoms and treatments online.’

One male patient commented: ‘It is hard for men to talk about these issues, having this resource available is a breakthrough. I would never have gone to the doctor with this and would still be suffering in silence.’

Normalising bladder weakness

Donna Wilson, TENA training and brand manager, says the brand is committed to
normalising bladder weakness and to making it less embarrassing for both men and women to seek advice and help.

‘Many people experiencing bladder weakness are opting to purchase protective products in pharmacy as they feel it is a safer environment to do so, and for this reason, bladder weakness is one of the fastest growing OTC categories in pharmacy,’ she explains.

Talking to customers about the category is vital. ‘Men and women who feel embarrassed shopping the category may not feel comfortable spending time browsing the complete range offered by TENA, therefore it is important to open up a dialogue and ensure the correct absorbency is being purchased, while reassuring the customer their experience is very normal.’

Ms Wilson reminds pharmacy staff they should look out for women buying large volumes of sanitary protection, as this may be an indication that the customer is experiencing bladder weakness but is unaware of, or too embarrassed, to seek advice on the correct product.

TENA offers an array of comprehensive training programmes and resources for pharmacists and pharmacy support staff, to ensure they have up-to-date knowledge of bladder weakness and the skills to discuss this with customers,’ adds Ms Wilson.

The battle against snoring

Snoreeze has taken positive steps to help people who self-diagnose online get the correct information about snoring. ‘There’s no doubt that self-diagnosis is a growing trend; that’s why we’ve focused heavily on providing easy-to- understand content on our new site –,’ explains product manager Daniel Bourhill. ‘Sleep apnoea, which is closely related to snoring, can be particularly dangerous,’ he says.

Mr Bourhill explains that care over merchandising and placement is also helpful for customers who might feel embarrassed and who do not want to ask for a product.

‘Merchandising is an important factor. In Boots we’re merchandised in the sleep category which is really simple for people to understand, but in independent pharmacy we’re often found in cough and cold, which can give consumers conflicting messages.’

He also notes that most customers looking for products are women – who are often the ‘suffering’ partners rather than having the problem themselves. ‘We try to help our customers fight their battle against snoring in any way we can.’ I“t is important to open up a dialogue... while reassuring the customer their experience is very normal

Fighting bad breath

The nation’s breath is not as fresh as it could be. The British Dental Health Foundation commissioned a survey into the subject of halitosis and discovered that 20 per cent of people would describe their partner as having bad breath, with a further 42 per cent complaining about the oral hygiene of their work colleagues.

World Oral Health Day, to be held on 20 March, will focus on protecting the teeth and mouth throughout life. ‘Over 90 per cent of the world’s population will suffer from some form of dental disease in their lifetime, but many of these can be treated or prevented with a good oral health routine,’ comments FDI World Dental Federation president Dr Tim Chun Wong. ‘We want to celebrate healthy smiles’. Sponsors of the international event include the Listerine mouthwash brand from Johnson & Johnson, Unilever and the Wrigley Oral Healthcare Program.

Adults with acne

Mild to moderate acne can be a hugely embarrassing problem for teens, but it is an equally sensitive problem when adults are hit with an unexpected outbreak.

Teenagers in particular are much more likely to seek advice online, says a spokesperson from Clearasil. ‘Consultation rooms in pharmacy areas would help acne sufferers get the best advice, but for teens, that would be too embarrassing, so screen-based guidance is what they go for every time. For teens, self-diagnosis, then buying the ight products, works for most.’

‘The web can actually be very helpful in suggesting other formats which are relevant to the teen's lifestyle, such as wipes or pads for use after sport, and reinforcing the message that you have to use spot treatment products for several weeks, if not months, to get a clear skin.’

With adults, however, self-diagnosis can be unhelpful, as conditions such as rosacea, which can be mistaken for acne, may be worsened by conventional acne treatments. As there’s more likely to be an underlying cause to sudden acne breakouts in adults, Clearasil recommends that customers are referred to experts.

‘Exposure to chlorinated chemicals and oils can cause moderate to severe acne on the face, chest and back and dermatologist advice is needed to deal with this. Acne can also be evidence of problems such as polycystic ovary syndrome – a GP or dermatologist visit will provide the correct diagnosis.’

Excessive flatulence

Excessive flatulence isn’t something that most people like to admit to, even to a pharmacist, but in addition to being a symptom of digestive conditions such as IBS, it can be distressing and uncomfortable in itself.

JL Bragg Ltd has recently relaunched Charcoal Biscuits, previously unavailable for many years, and has produced a consumer leaflet to explain the health benefits of activated charcoal, which they are happy to send to pharmacies.

‘Embarrassment about flatulence is very real, and asking the pharmacist or the counter staff is off-putting for many sufferers,’ comments sales manager John Heywood. ‘They scour the shelves to find suitable products, and may end up purchasing less suitable and effective products.’

Avoiding smoking, de-stressing and sleeping well are among the lifestyle modifications recommended to minimise bowel problems by the Love Your Gut campaign (


Pharmacies can try different ways for having information available for people about the conditions that are more embarrassing to discuss. 

Bipin Patel, Broadway Pharmacy, Bexleyheath ‘We try to demystify some of the pre-conceived ideas people have with regards to incontinence and acne by explaining what’s causing their problem. Pharmacy could expand on its over the counter sales in this category by making people more aware of what’s available. You need to make sure that you have a dedicated section with supporting products and good signposting so customers can find what they’re looking for. Some of the items could go in self-selection and you could try to put them in a quiet part of the shop so customers don’t feel embarrassed about what they are looking for. If you’ve got sensitive products right in the middle of the shop that might not be good but if they’re too far away from the beaten track people might not be able to find them. It is about getting the balance right.’


Ramesh Patel, Brownes Chemist, Abbey Wood, London ‘This is an important category from the point of view of the patient. Occasionally people come in with excess sweat problems but if the issue persists we suggest they visit their GP about it. Haemorrhoids are also a problem that customers need advice about. If a customer has vaginal thrush then we suggest the Canesten cream and capsules to clear it up. If they have a persistent problem then we point them in their GP’s direction because it could be diabetes or something else, which is at the root cause. If a customer feels uncomfortable talking about their problem, it is a good idea to take them to one side and invite them into the consultation room.’ 


Nawaz Mohamed, locum pharmacist, Sheffield ‘For this category product posters should be clearly displayed as patients may not realise that certain products can be obtained from the pharmacy. Pharmacies can also negotiate better deals on the most recommended household names such as Canesten. One of the main challenges is the personal nature of some of these conditions. However, this can provide an opportunity for pharmacy to make a positive impact. For example, products can be placed near to confidentiality screens on the healthcare counter, which would provide a discreet area for pharmacists and healthcare staff to talk to patients and recommend the correct products.’ 



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