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Children’s toothache is becoming everybody’s business: where do parents go when their children have oral pain in London, England? A cross-sectional analysis
  1. Vanessa Elaine Muirhead1,
  2. Zahidul Quayyum2,
  3. Donal Markey3,4,
  4. Sally Weston-Price1,
  5. Annette Kimber3,
  6. Wayne Rouse3,
  7. Cynthia M Pine1
  1. 1 Centre for Dental Public Health and Primary Care, Institute of Dentistry, Queen Mary University of London, London, UK
  2. 2 Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, London, UK
  3. 3 Dental, Optometry and Pharmacy Commissioning, NHS England London Region, London, UK
  4. 4 Children & Young People Programme, Healthy London Partnerships, London, UK
  1. Correspondence to Dr Vanessa Elaine Muirhead; v.muirhead{at}qmul.ac.uk

Abstract

Objectives To assess the number of parents who visited community pharmacies in London seeking pain medications for their children’s pain and specifically for oral pain, to identify which health services parents contacted before their pharmacy visit and to estimate the cost to the National Health Service (NHS) when children with oral pain who visit pharmacies also see health professionals outside dentistry.

Design A cross-sectional study.

Setting 1862 pharmacies in London in November 2016–January 2017.

Participants Parents, carers and adolescents purchasing over-the-counter pain medications or collecting pain prescriptions for children (0–19 years).

Brief intervention A survey administered by pharmacy staff to participants and a guidance pack.

Main outcome measures The number of parents who visited pharmacies seeking pain medications for their children’s pain and oral pain and the number of parents who contacted health professionals outside dentistry before their pharmacy visit. Estimated costs of visits by children with oral pain to health professionals outside dentistry.

Results One in two (951) pharmacies participated collecting information from 6915 parents seeking pain medications for their children. The majority (65%) of parents sought pain medications to relieve their children’s oral pain. Only 30% of children with oral pain had seen a dentist before the pharmacy visit, while 28% of children had seen between one and four different health professionals. The cost to the NHS of children contacting health professionals outside dentistry was £36 573, extrapolated to an annual cost of £373 288. Replicating these findings across all pharmacies in England could mean that the NHS spends an estimated £2.3 million annually when children with oral pain inappropriately use multiple health services.

Conclusion Most parents who visited pharmacies for children’s pain medications in London sought pain medications for children’s oral pain. Children’s inappropriate contact with multiple health services when they have oral pain adds significant costs to the NHS.

  • organisation of health services
  • community child health
  • pain management
  • primary care
  • public health

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors VEM designed the study and brief intervention; she wrote the statistical analysis plan, analysed the data and drafted and revised the paper. She is the guarantor. ZQ advised on the cost analysis and drafted and revised the paper. DM initiated the collaborative project, helped to develop the brief intervention and revised the paper. SW-P helped to develop the brief intervention and revised the draft paper. WR and AK designed the brief intervention, monitored data collection for the survey and revised the draft paper. CMP helped to develop the study design and revised the draft paper.

  • Funding This research was funded by NHS England London Region. Donal Markey was partly funded by Healthy London Partnerships.

  • Disclaimer The present paper represents the opinions of the authors and does not necessarily reflect the position of their employers.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.