Seventeen participants who had recently had RTI or flu symptoms (10 female, 16 white, one south Asian) were interviewed between 3 and 8 days after their pharmacy visit.17 The eight participants who had visited a pharmacy and not their GP surgery did not report that their illness was affecting their day to day life, (Box 1) and did not describe pain as a symptom. The nine participants who had also visited their GP had two things in common: their symptoms affected day-to-day life, sleep, or activities, and they described symptoms that included pain (Box 2). Several participants mentioned that they had visited their GP because they wanted reassurance, or were prompted to go by family or friends. Several participants reported that they would not expect antibiotics for a cough or cold, but would if symptoms were prolonged or severe, or if they had an underlying illness such as asthma (Box 3).
Box 1. Why participants reported they did NOT visit their GP surgery
RTI wasn’t affecting everyday life:
P34: ‘…. although I’ve been, like, runny nose, sore throat, I haven’t really been, sort of, like I didn’t want to get out of bed, or, you know, I just took some tablets — some paracetamol — and just got up and got on with things really.’
Don’t visit GP surgery with minor illness:
P25: ‘No I didn’t, no. No, I wouldn’t take up their time with something as simple as that.’
P34: ‘Because the pharmacy are so helpful, I usually tell them what the symptoms are and they’ll tell you basically what the doctor would tell you, the only thing the pharmacy can’t do is obviously prescribe antibiotics, and because we’d been to the GP 3 weeks prior to that and he’d had a chest infection but that had cleared up I just thought well, I’m not one of these people that likes to be in the doctors surgery all the time, and I will only take them if it is really bad and they need to go to the doctors.’
Know the GP won’t give any antibiotics:
P35: ‘because I knew, um, the GP couldn’t give me anything, any that I couldn’t buy to make myself feel better. I knew they wouldn’t give me antibiotics.’
Box 2. Why participants reported they visited their GP surgery
Symptoms were interfering with sleep:
P39: ‘Hard to breathe, hard to sleep, pains in my stomach through coughing and the chest. I’d just had enough I couldn’t cope anymore.’
Interviewer: ‘Okay was it affecting your day-to-day life?’
P39: ‘It was yeah, because I was, I just wasn’t able to sleep at nights.’
Reassurance that illness didn’t require further treatment:
P26: ‘Erm because in previous times when it hasn’t cleared up in a few days it usually means she has got an ear infection or something, so I wanted to make sure really.’
P35: ‘It’s peace of mind really. They do more of an examination like listening to the chest and, you know, examining them more.’
Symptoms persistent:
P13: ‘Yeah, it was probably Sunday and I probably didn’t go on the Sunday because I was just staying in because I wasn’t very well over the weekend. So, it’s probably in the start of the week, when I wanted my system to start feeling better [that I went to the GP].’
Severity of illness affecting day to day activities:
P33: ‘Yeah I did [visit GP], I had been taking over-the-counter tablets, I started them at the beginning when I had my cold but I just didn’t feel that they were doing anything at all, so I felt as if I needed something stronger. So it makes me feel so rotten that’s why I felt I had to go to the doctors.’
Family or peer pressure to visit GP:
P6: ‘Because it didn’t stop me going out with the dog or anything like that, it was only when my breath became inhibited somewhat that I thought, and the nagging of others, that I should really take some medical advice.’
Box 3. Why participants expected antibiotics
Symptoms or illness severe enough to warrant antibiotics:
P39: ‘You just wait and see and try and ride it out yourself. Until or if it affects you too much ... This time because I’m in a different kettle of fish now because I’m asthmatic it’s hit me more than any other flu or cold that I’ve ever had. Simply because I’m asthmatic and the only thing that would deal with me then was antibiotics, which I’m on now, I’m only on my third day and I have felt improvements.’
P34: ‘I can look at my children and I know when they’re seriously ill, and that’s when you know as a mum you can look and you know in yourself, obviously when you can’t move, you can’t ... everything, then everything hurts, you shiver and you shake. There’s just so many different symptoms and it’s if you’ve got the whole lot in one go and you don’t get any better like within 2 days nothing helps, then I’d say you need antibiotics, if nothing else does the job.’
