Download - Training your team: Foot conditions exercise · • Fungal nail treatments often penetrate the nail bed • Amorolfine (e.g. Schollmed Once Weekly Fungal Nail Treatment 5% w/v Medicated

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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Tolnaftate

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Customer profile

• Hertoenailisthick,scalyandwithyellowstreaks

• Itisstartingtopullawayfromherskin

• Shehasusedteatreeoiltohelpimprovehernails

• Sheisnottakinganyothermedicines.

Didyourteammembercorrectlyidentifyafungalnailinfectioninthiscustomer?Didtheycheckiftheyalsohadskinsymptoms,asathlete’sfootcanleadtofungalnailinfections?3Ifnot,moreinformationonfootconditionsisavailableviaadownloadablesummarysheet.


• Fungalnailtreatmentsoftenpenetratethenailbed

• Amorolfine(e.g.SchollmedOnceWeeklyFungalNailTreatment5%w/vMedicatedNailLacquer)isrecommendedasafirst-line,OTCchoiceforfungalnailinfections6

• Teatreeoilisnotrecommendedfortreatingfungalnailinfections.6

Was treatment advice offered?

• Amorolfinelacquershouldbeappliedweeklyfor9-12monthsfortoenailsor6monthsforfingernailinfections.6


• Thisissimilartotherecommendationsforathlete’sfoot:dryingthoroughlybetweenthetoes,wearingbreathableshoes,wearingprotectivefootwearincommunalareasandavoidingsharingtowelsornailclippers.7


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.


• Untilrecently,ingrowingtoenailcouldonlybetreatedbyadoctor

• Amedicaldeviceisnowavailabletostraightenthetoenailbyencouragingtheedgesofthenailtoliftupwards,awayfromtheskinandhencegrowoutstraight8

• Itcanoffercustomersimmediaterelief

• Thisstraighteningtreatmentissuitablefortheearlystagesofingrowingtoenail,i.e.whensymptomsaremildandthetoenailhasnotbrokenthesurroundingskin.

Was treatment advice offered?

• Themedicaldeviceshouldbeusedweeklyforsixweeks,bywhichtimethenailshouldhavegrownout.8


• Guidanceonhowtocuttoenailscorrectly,e.g.cuttoenailsafterabathorshowerwhenthenailsaresofterandcutstraightacross,notdownthesidesortoolowatthenailedges.9


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

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/0417/0005beDateofpreparation:January2018

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