Community pharmacist interventions in ear health: a scoping review

Taylor, Selina, Cairns, Alice, Solomon, Shaun, and Glass, Beverley (2021) Community pharmacist interventions in ear health: a scoping review. Primary Health Care Research and Development, 22. e63.

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Background: In Australia, around 3.6 million people suffer from hearing loss, more than 1.3 million with preventable hearing conditions. Ear diseases are prevalent in Indigenous populations, particularly children and are associated with poor educational outcomes and subsequent high rates of unemployment and incarceration. In Australia, rural and remote communities have rates of middle ear perforations five times the rate that the World Health Organisation regards to be a significant public health problem. Barriers to accessing ear health services have been identified including gaps in testing during the 'early years' and difficulty in accessing these services. Reducing the risk of hearing loss through improved ear health care can directly impact the ability to learn and develop. Collaboration between community, health providers and government is crucial to ensure necessary support for change. An opportunity presents for rural community pharmacists, who are both qualified and accessible to provide an ear health programme and thus improve health outcomes for both Indigenous and non-Indigenous Australians in their communities. Aim: The aim of this study was to identify published evidence of pharmacists' involvement in ear health care interventions to inform the development of ear health services able to be delivered in rural community pharmacy in Australia. Data sources: The search strategy was applied to the following electronic databases: MEDLINE, Scopus, CINAHL, Emcare, Cochrane, Google Scholar and Google. Study selection articles were included if they described an ear health intervention in a community pharmacy setting. The interventions reported in the articles were evaluated for their inclusion of effectiveness, whether the service was sustainable, and the inclusion of enablers and barriers to the provision of ear care. The articles were also thematically analysed using the Deadly Ears Deadly Kids Deadly Communities Framework. A total 8427 articles were identified and evaluated against inclusion and exclusion criteria, with eleven eligible articles suitable for inclusion in the review. The articles included were conducted in Australia (n = 4), England (n = 4), United States of America (n = 2) and Brazil (n = 1). The ear health interventions identified included hearing screening (n = 3), otoscopy pilot studies (n = 2), audiometry services (n = 1), specific education for undergraduate pharmacy students (n = 2) and a pharmacy-based clinic (n = 3). Effectiveness and sustainability were not formally reported in any of the included articles. Positive outcomes, funding availability, consumer access to community pharmacy, cost savings for consumers and improved connection to health providers were identified as enablers. Difficulty in attracting funding was the most commonly reported barrier. Conclusions: Improving ear health of both Indigenous and non-Indigenous peoples through services provided in community pharmacy presents as an important opportunity for rural pharmacists. Pharmacists are accessible and thus well placed to improve ear healthcare and resultant quality of life for these vulnerable populations. This review has identified factors required to effectively develop ear health models of care in community pharmacy including a pharmacist training program, continuous funding to ensure sustainability and support from pharmacy stakeholders and the community.

Item ID: 72105
Item Type: Article (Research - C1)
ISSN: 1463-4236
Keywords: ear health,expanded pharmacy practice,Indigenous ear health,models of care pharmacy practice,scope of practice
Copyright Information: © The Author(s), 2021. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Funders: National Health and Medical Research Council (NHMRC)
Projects and Grants: NHMRC-funded Fellowship ‘Improving Health Outcomes in the Tropical North: A multidisciplinary collaboration (Hot North)’, grant identification number: 1 131 932
Date Deposited: 09 Feb 2022 08:31
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420321 Rural and remote health services @ 60%
42 HEALTH SCIENCES > 4203 Health services and systems > 420312 Implementation science and evaluation @ 40%
SEO Codes: 28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280112 Expanding knowledge in the health sciences @ 20%
20 HEALTH > 2099 Other health > 209999 Other health not elsewhere classified @ 80%
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