# Patient conversations that matter: assessing the role of TARGET TYI leaflets for respiratory care in England’s community pharmacies

## TL;DR

This study shows that using TARGET TYI leaflets in community pharmacies helped manage respiratory infections better, reduced the need for escalation, and supported patient self-care.

## Contribution

The study demonstrates the effectiveness of incentivizing the use of TYI leaflets in community pharmacies to improve antibiotic stewardship and patient care.

## Key findings

- The proportion of patients needing escalation to a pharmacist dropped from 23% to 15% after using the leaflets.
- Over 80% of patients accepted over-the-counter remedies, and nearly all received self-care advice.
- Incentivization led to widespread adoption of the leaflets by pharmacies, improving healthcare efficiency.

## Abstract

The TARGET Treating Your Infection (TYI-RTI) leaflets are designed to support healthcare professionals in delivering tailored conversations with patients about respiratory tract infection (RTI) symptoms. This study evaluated their use across community pharmacies in England through the Pharmacy Quality Scheme (PQS).

In 2022–23 and 2023–24, the PQS incentivized community pharmacies to use TYI-RTI leaflets for patients presenting with upper RTIs during a 4 week period each year.

Across the 2 years, 225 615 patients were reviewed using TYI-RTI leaflets. A total of 7525 pharmacies participated in at least 1 year, with 7407 taking part in both. The proportion of patients requiring escalation to the pharmacist fell from 23% (26 678) in 2022–23 to 15% (16 417) in 2023–24. Approximately one-third of patients were managed entirely by the wider pharmacy team. Signposting to another healthcare provider also declined, from 12% (13 248) to 7% (8250; P < 0.001), with immediate escalation reducing from 6% (6859) to 4% (4075; P < 0.001). Most patients were offered over-the-counter (OTC) remedies—85% (97 551) in 2022–23 and 89% (98 343) in 2023–24 (P < 0.001)—with high acceptance rates (80% and 84%, respectively). Self-care advice was provided to almost all patients [95% (109 474) in 2022–23; 97% (106 770) in 2023–24; P < 0.001]. Around one-third received additional written information in both years [31% (35 624) and 31% (34 242)].

Community pharmacies successfully used TYI-RTI leaflets to support patient self-care, reassurance and safety-netting, reducing the need for escalation. The study highlights the role of TYI-RTI in optimizing pharmacy-led RTI management and reducing pressure on wider healthcare services. Incentivization was an effective tool for improving AMS in community pharmacy at pace.