Training your team: Foot conditions exercise · • Fungal nail treatments often penetrate the nail...
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Training your team: Foot conditions exercise Customer profile • The skin between his toes is also white and soggy • He has had symptoms for a couple of weeks • He goes to the gym and runs regularly • He has no other health problems and is not taking any other medicines. Did your team member correctly identify athlete’s foot in this customer? Did they check symptoms affecting the nail, as athlete’s foot can lead to fungal nail infections? 3 If not, more information on foot conditions is available via a downloadable summary sheet. What treatment was suggested? • Topical anti-fungal treatments (e.g. Scholl Athlete’s Foot Spray Liquid/Foot Powder both contain Tolnaftate) are OTC treatments available for athlete’s foot 4 • Some anti-fungals are available in combination with hydrocortisone cream to reduce inflammation; 4 these should be used for short periods only. 4 Was format considered? • Topical anti-fungals are available in a wide range of formats, such as creams, ointments, gels, sprays, liquids, powders and pens • Duration of use should also be considered; some treatments have to be applied a couple of times a day, and for around 1-2 weeks after the skin has cleared up, to prevent re-infection. 5 What lifestyle advice was offered? Offering lifestyle advice showcases the added value pharmacy have in customer care. Tips can include: • Drying thoroughly between the toes, wearing cotton socks and breathable shoes, wearing protective footwear in the gym and showers and avoiding sharing towels. 3 Full information is available in the managing foot conditions module. Surveys have found 30% of pharmacists deal with foot problems at least once a week 1 and customers often go to a pharmacy for footcare advice. 2 As a team, role play how you would manage the following customers. Have your team/team member play their usual role, while you take the part of the customer. Customer 1: A 23-year old man: “What works for cracked skin between my toes?” FOOTCARE HUB Tolnaftate Your pharmacy training 1
Transcript of Training your team: Foot conditions exercise · • Fungal nail treatments often penetrate the nail...
Training your team: Foot conditions exercise
Customer profile
• Theskinbetweenhistoesisalsowhiteandsoggy
• Hehashadsymptomsforacoupleofweeks
• Hegoestothegymandrunsregularly
• Hehasnootherhealthproblemsandisnottakinganyothermedicines.
Didyourteammembercorrectlyidentifyathlete’sfootinthiscustomer?Didtheychecksymptomsaffectingthenail,asathlete’sfootcanleadtofungalnailinfections? 3Ifnot,moreinformationonfootconditionsisavailableviaadownloadablesummarysheet.
What treatment was suggested?
• Topicalanti-fungaltreatments(e.g.SchollAthlete’sFootSprayLiquid/FootPowderbothcontainTolnaftate)areOTCtreatmentsavailableforathlete’sfoot4
• Someanti-fungalsareavailableincombinationwithhydrocortisonecreamtoreduceinflammation;4theseshouldbeusedforshortperiodsonly.4
Was format considered?
• Topicalanti-fungalsareavailableinawiderangeofformats,suchascreams,ointments,gels,sprays,liquids,powdersandpens
• Durationofuseshouldalsobeconsidered;sometreatmentshavetobeappliedacoupleoftimesaday,andforaround1-2weeksaftertheskinhasclearedup,topreventre-infection.5
What lifestyle advice was offered?
Offeringlifestyleadviceshowcasestheaddedvaluepharmacyhaveincustomercare.Tipscaninclude:
• Dryingthoroughlybetweenthetoes,wearingcottonsocksandbreathableshoes,wearingprotectivefootwearinthegymandshowersandavoidingsharingtowels.3
Fullinformationisavailableinthemanagingfootconditionsmodule.
Surveyshavefound30%ofpharmacistsdealwithfootproblemsatleastonceaweek1andcustomersoftengotoapharmacyforfootcareadvice.2
Asateam,roleplayhowyouwouldmanagethefollowingcustomers.Haveyourteam/teammemberplaytheirusualrole,whileyoutakethepartofthecustomer.
Customer 1: A23-yearoldman:
“What works for cracked skin between my toes?”
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Customer profile
• Hertoenailisthick,scalyandwithyellowstreaks
• Itisstartingtopullawayfromherskin
• Shehasusedteatreeoiltohelpimprovehernails
• Sheisnottakinganyothermedicines.
Didyourteammembercorrectlyidentifyafungalnailinfectioninthiscustomer?Didtheycheckiftheyalsohadskinsymptoms,asathlete’sfootcanleadtofungalnailinfections?3Ifnot,moreinformationonfootconditionsisavailableviaadownloadablesummarysheet.
What treatment was suggested?
• Fungalnailtreatmentsoftenpenetratethenailbed
• Amorolfine(e.g.SchollmedOnceWeeklyFungalNailTreatment5%w/vMedicatedNailLacquer)isrecommendedasafirst-line,OTCchoiceforfungalnailinfections6
• Teatreeoilisnotrecommendedfortreatingfungalnailinfections.6
Was treatment advice offered?
• Amorolfinelacquershouldbeappliedweeklyfor9-12monthsfortoenailsor6monthsforfingernailinfections.6
What lifestyle advice was offered?
• Thisissimilartotherecommendationsforathlete’sfoot:dryingthoroughlybetweenthetoes,wearingbreathableshoes,wearingprotectivefootwearincommunalareasandavoidingsharingtowelsornailclippers.7
Fullinformationisavailableinthemanagingfootconditionsmodule.
Customer 2: A46-yearoldwoman:
“I need something to cover up my ugly toenail.”
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Customer 3: A32-yearoldwoman:
“I need a corn pad to help ease my painful toe.”
Did the team ask WWHAM questions to get the below information?
• Shehasred,swollenskinaroundthesidesofhertoenail,althoughthenailhasnotpiercedtheskin
• Itisalsopainfultotouch
• Sheisnottakinganymedicines,asidefromtheoralcontraceptivepill.
Didyourteammembercorrectlyidentifyaningrowingtoenail?Ifnot,moreinformationonfootconditionsisavailableviaadownloadablesummarysheet.
What treatment was suggested?
• Untilrecently,ingrowingtoenailcouldonlybetreatedbyadoctor
• Amedicaldeviceisnowavailabletostraightenthetoenailbyencouragingtheedgesofthenailtoliftupwards,awayfromtheskinandhencegrowoutstraight8
• Itcanoffercustomersimmediaterelief
• Thisstraighteningtreatmentissuitablefortheearlystagesofingrowingtoenail,i.e.whensymptomsaremildandthetoenailhasnotbrokenthesurroundingskin.
Was treatment advice offered?
• Themedicaldeviceshouldbeusedweeklyforsixweeks,bywhichtimethenailshouldhavegrownout.8
What lifestyle advice was offered?
• Guidanceonhowtocuttoenailscorrectly,e.g.cuttoenailsafterabathorshowerwhenthenailsaresofterandcutstraightacross,notdownthesidesortoolowatthenailedges.9
Fullinformationisavailableinthemanagingfootconditionsmodule.
References
1.RobinsonJ.PharmJ,2017;299:S2-S3.2.RBDataonFile.Schollfootconditionsresearch.2006(n=9832).3.NHSChoices.Athlete’sfoot.AccessedJanuary2018.http://www.nhs.uk/conditions/Athletes-foot/Pages/Introduction.aspx4.NICEClinicalKnowledgeSummaries.Fungalskininfection-foot.September2014.AccessedJanuary2018.https://cks.nice.org.uk/fungal-skin-infection-foot5.BritishNationalFormulary.Skininfections.AccessedJanuary2018.https://bnf.nice.org.uk/treatment-summary/skin-infections.html6.NICEClinicalKnowledgeSummaries.Fungalnailinfection.September2014.AccessedJanuary2018.https://cks.nice.org.uk/fungal-nail-infection7.NHSChoices.Fungalnailinfection.AccessedJanuary2018.http://www.nhs.uk/Conditions/Fungal-nail-infection/Pages/Introduction.aspx8.RBDataonFile.2015.9.CollegeofPodiatry.Ingrowingtoenail.AccessedJanuary2018.http://www.scpod.org/foot-health/common-foot-problems/ingrowing-toenail
Essential Information
Scholl Athlete’s Foot Powder. Active ingredient: ContainsTolnaftate1.0% w/w. Indications:ForthepreventionandtreatmentofAthlete’sFoot(GSL).MA Holder:SchollConsumerProductsLtd,SL13UH.MRRP: £4.99.Informationaboutthisproduct,includingadversereactions,precautions,contra-indications,andmethodofusecanbefoundat:http://www.medicines.org.uk/emc/medicine/4514PreparedOctober5th,2016
Scholl Athlete’s Foot Spray Liquid. Active ingredients:Tolnaftate0.068%w/w,todeliver1%totheskin.Indications:ForthepreventionandtreatmentofAthlete’sFoot(GSL).MA Holder: SchollConsumerProductsLtd,SL13UH.MRRP:£4.49.Informationaboutthisproduct,includingadversereactions,precautions,contra-indications,andmethodofusecanbefoundat:https://www.medicines.org.uk/emc/medicine/29392PreparedMarch2nd,2015
Schollmed Once Weekly Fungal Nail Treatment 5% w/v Medicated Nail Lacquer. Active ingredients: Each 1ml solution contains 55.74 mg amorolfine hydrochloride (equivalent to 50 mg amorolfine).Indications: Forthetreatmentofmildcasesofdistalandlateralsubungualonychomycosescausedbydermatophytes,yeastsandmoulds;treatmentislimitedto2nails.Dosage instructions:Forcutaneoususe(applicationonthenail)inadultsandelderly.Beforethefirstapplicationtheaffectedareasofnailshouldbefileddownandcleansedwithanalcoholcleaningpad.Thenaillacquershouldbeappliedtotheaffectedfingerortoenailsonceweekly.Beforeeveryweeklyapplicationnailshouldbecleansewithacleaningpadandfileddownasrequired.Notrecommendedforuseinchildrenandadolescentsbelow18years.Contraindications:Hypersensitivitytotheactivesubstances(s)ortoanyoftheingredients.Precuations and warnings:Avoidcontactofthelacquerwitheyes,earsandmucousmembranes.Patientswithunderlyingconditionspredisposingtofungalnailinfectionsshouldbereferredtoadoctorsuchconditionsincludeperipheralcirculatorydisorders,diabetesmellitus,andimmunosuppression.Patientswithnaildystrophyanddestroyednailplateshouldbereferredtotheirdoctor.Whenworkingwithorganicsolventswearimpermeableglovesinordertoprotecttheamorolfinelacqueronthenails.Duringtheapplicationofschollfungalnail5%w/vmedicatednaillacquernocosmeticnaillacquerorartificialnailsshallbeused.Useofnailvarnishorartificialnailsshouldbeavoidedduringtreatment.Caution: Nailfilesusedforaffectednailsmustnotbeusedforhealthynails.Treatmentshouldbecontinuedwithoutinterruptionuntilthenailisregeneratedandtheaffectedareasarefinallycured.Pregnancy and lactation: Amorolfineshouldbeavoidedduringpregnancyandbreastfeeding.Side effects: Rare:(≥1/10,000to<1/1,000)patientsmaydevelopanaildisorder,naildiscoloration,onychoclasis(brokennails)oronychorrhexis (brittlenails).Veryrare: (<1/10,000)patientsmayexperienceskinburningsensation.Frequency unknown:Erythema,pruritus,contactdermatitis,urticaria,blisters.ProductLicence Number:00063/0740.Legal classification: Pharmacyonly.Licence Holder: ReckittBenckiserHealthcare(UK)limited,103-105BathRoad,Slough,SL13UH,UK.MRRP: £23.99(2.5mlmedicatednaillacquer).PreparedJuly,2017
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Reckitt Benckiser
Healthcare (UK) Ltd on: 0333 200 5345.
UK
/CC
/0417/0005beDateofpreparation:January2018
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