Introduction
Vulvovaginal candidiasis (VVC) or vaginal thrush affects 75% of pre- menopausal women. Since 1992, a number of anti-fungal preparations have been re-classified from POM (Prescription only medicine) to P (Pharmacy only medicine) status. As a result, a woman is able to seek immediate relief from her symptoms rather than having to wait for an appointment with her general practitioner. There has been little evaluation of community pharmacists' beliefs and views about their role in treating vaginal thrush, particularly in the UK.

Method
A series of semi-structured interviews was conducted with community pharmacists to investigate their views about treating women for vaginal symptoms. Community pharmacists were recruited from within Grampian Primary Health Care NHS Trust. Purposive sampling was used to identify pharmacists from different types of pharmacies (independent, small and large multiples) and locations (deprived/affluent inner city, rural), as their experience of treating vaginal symptoms was likely to be influenced by these factors. The interviews were conducted in a face-to-face setting and by telephone, using an interview schedule. Responses to open-ended questions were categorised using content analysis.

Results
Of the 26 pharmacists contacted, 19 (73%) completed interviews. The average age of the pharmacists was 35 years (range: 24 to 59) and their average duration of professional registration was 11 years (range: 2 to 36). The main advantages to women were perceived to be symptom relief, rapid treatment and reducing the risk of spreading the infection. The main disadvantages to the patient were cost, embarrassment and the risk of masking a serious condition. The main advantages to the pharmacist were job satisfaction, being able to help people and increasing patient awareness regarding pharmacists' abilities in treating minor illness. The main facilitators to treating women with vaginal symptoms were a clear patient history, access to a quiet area and having a previous history of thrush. The main barriers to treatment were patient embarrassment, lack of privacy and incomplete information from the patient. Six pharmacists thought that their personal experience of thrush had influenced their treatment of women presenting with this condition.

Conclusions / Discussion
The pharmacists were positive towards the treatment of women with vaginal symptoms in community pharmacies. The results raised a number of issues. The belief that thrush can be "spread" if rapid treatment is not provided is not supported by the evidence. Access to a private area to enable confidential and sensitive questioning is an issue that cannot be resolved easily for pharmacists working in premises with no available resources. Having such a location may help to minimise the embarrassment experienced by some women who require treatment for conditions of this nature. Further research is required to determine whether the opinions expressed by the pharmacists in this study are representative of community pharmacists in general. The results of this study are being used to inform the development of a regional questionnaire survey that will investigate this issue.