Background
The UK NHS Plan (2000) has recognised that community pharmacists are well placed to support the use of over-the-counter medicines (OTC) in people with minor ailments. The NHS R&D strategic review of primary care [1] identified the need for more research in OTC use. We know that children with minor ailments are frequently treated with OTCs [2] but there is little evidence of the extent and nature of self-medication.

Objectives
To analyse minor ailments in children presented in community pharmacies and the types of OTC purchased in response.

Method
Eight community pharmacies were selected in East Yorkshire using stratified randomisation (urban, suburban and rural). Data was collected during one week every month for one year. The data collection weeks were selected using a random table prior to the start of the study. The pharmacy staff completed a data collection form based on the protocol used in response to symptoms [3] each time a customer consulted or purchased an OTC for treating a minor ailment in an under 16 year old.

Results
Data was analysed using SPSS. In twelve months 976 requests were recorded giving an average of 10.2 requests per pharmacy per week. 52% were for boys with a mean age of 5.6 years. Counter assistants were involved in the majority of consultations initially (79%) although 16% were referred to the pharmacists.

Although the most common symptoms - fever (16.1%), coughs (15%), runny or blocked nose (12.1%), headaches (8.1%), sore throat (6.1%) were treated with analgesics and cough and cold remedies, a wide range of other symptoms: head lice (5.7%), diarrhoea (3.2%), earache (3.1%), teething (2.5%), rashes (2.5%), warts and verrucas (1.5%) were presented and treated. Worryingly, there were five requests for aspirin for children that were obviously refused.

Paracetamol was the most frequently requested treatment (31%) and purchased (38.2%), followed by preparations for coughs and colds (requested 6.3%, purchased 18.6%), non-steroidal anti-inflammatory agents (requested 7.4%, purchased 10.3%), head lice insecticides (requested 3%, purchased 8.2%), and antihistamines (requested 3.6%, purchased 7.3%)

Before visiting the pharmacy, 57% of the customers had used no treatment, 22.4% used medicine at home, 14.5% consulted a doctor and 6.3% used a home remedy. The outcome of consultation was 93% purchased medicine, 5% referred to doctor, and 2% were given counselling only.

Conclusion
The study illustrates the significance of the community pharmacy as a first port of call for minor ailments in children, and opportunity for referral to GPs when necessary. We also learnt about parents' more limited knowledge of some types of OTC medicines and still misunderstanding over the safety of aspirin. This demonstrates the importance of the pharmacist's advice and supervision of sales.

1. NHS R&D A strategic Review Primary Care. Report of Topic Group 1999

2. Birchley N, Conroy S. Over the counter medicines in childhood: Issues and concerns. A Narrative review of the literature. Paediatric and Perinatal Therapy 2001;4(4): 161-7

3. Blenkinsopp A, Paxton P. Symptoms in the Pharmacy - A guide to the management of common illness. 2^nd Edition, Blackwell Science; 1996