You sound like a good boss to have, Jala.

I think there's nothing better than practice.

So if we're talking about pharmacy assistants, they're obviously doing the required S2S3 training in order to recommend medicines.

Coming into this time of the year, they're going to have plenty of opportunity to interact with patients that have got cough, obviously knowing when to refer back to the pharmacist.

And That will come with their training, but it will also depend on what the individual pharmacist's preferences are around when to refer.

Usually a pharmacy assistant will refer when there's other medicines or other health conditions that the patient has, or if they're asking about a symptom as opposed to an actual product, they'll involve the pharmacist.

But the pharmacist might have other preferences around when to refer as well.

Some really great tips there, Jarlath.

Then on the other hand, if it's a chesty or a productive cough, they can use a expectorant like guafenicin or a mucolytic such as bromhexine at the recommended doses and again for the shortest time possible.

Yeah, so obviously we have to understand what ages the product is recommended for.

A younger person is going to have more of a chance of that cough developing into something that is potentially more serious that might need antibiotics if there's a bacterial infection that overlays that.

Same with an older person who might not be able to clear the mucus as well from the cough reflex, then their risk of developing mucus Pneumonia, for example, is increased.

So not saying that we can't treat a younger person or an older person, but to just keep in mind of those risks and the need to refer on for further investigation should the cough not clear up or should it get worse or should it last for longer than what we would expect it to last for.

Thinking about their other health conditions, particularly other respiratory conditions, but then in older people, we have to think about other cardiovascular conditions, particularly with those more serious chest infections that can have a devastating impact on the cardiovascular system.

So deciding whether or not pharmacy treatment is appropriate, choosing the right one, but then giving the patient advice or their carer advice around what to do next.

Can you explain the clinical role of mucolytics to patients?

And so it is for that reason so important that you have access to a pharmacist or someone within the pharmacy team to help address those information gaps and concerns and then talk through potential interactions that might exist with the patient's other medicines as well.

Sure.

I mean, pharmacists will know it's a very big part of the market.

Usually in a pharmacy, the OTC medicines are very high in the list of the fast movers and cough would be a part of that, particularly coming into the winter season, as you said.

We have to obviously identify that there are differences between storage of those medicines.

Where I am in Queensland, they're stored behind the counter.

And so self-selection is less direct.

And when we're looking at choosing a cough product, can you highlight some important criteria a pharmacist needs to consider?

And do patients themselves recognise a dry or a chesty cough?

It's very challenging.

I mean, the language that they use will depend on their individual choices.

I guess the question is, can a patient tell the difference between a dry cough and a chesty cough or the combination of the two? I would say in many circumstances, yes.

If they've got that kind of barking cough and they don't feel the rattliness of mucus in their chest, then they will probably say that it's a dry cough.

But they might just say it's in my chest, for example, and that doesn't necessarily indicate to the pharmacist or the pharmacy assistant without further investigation whether or not there's mucus there or it's just a dry cough.

So I think ultimately we do have to ask those relevant history questions about symptoms in order to help the patient determine whether or not it's a dry or a chesty cough or a combination of the two.

Can you describe the different stages of the cough journey?