Plain Language Summary: Holistic care in mild upper respiratory tract infections (MURTIs): an approach to individualized care management
Mild upper respiratory tract infections (MURTIs), sometimes incorrectly termed the ‘common cold’, are caused by viruses and affect the nose, sinuses, pharynx, and larynx. Symptoms often include sore throat, congestion, sneezing, headache, fatigue and cough, typically starting staggered but quickly progressing to a peak where multiple symptoms are present. Though generally self-limiting (resolving on their own), MURTIs can significantly reduce a patient’s quality of life and result in substantial healthcare costs and lost workdays.
Since MURTIs are caused by various viruses, there is no cure; thus, management focuses on symptom relief. Patients often seek comprehensive, holistic strategies rather than isolated symptom relief. Common self-care and over-the-counter (OTC) options include home remedies, vitamins, and herbal products like those containing menthol or eucalyptol.
Patients generally follow one of three pathways:
1. Self-care-oriented: Relying on home remedies, OTC drugs, rest and increased fluid intake.
2. Pharmacist-oriented: Consulting pharmacists for OTC medication and health advice. Pharmacists are easily accessible and well-suited to manage MURTIs.
3. Physician-oriented: Visiting a general practitioner (GP) for severe or prolonged symptoms, seeking reassurance, or expecting an antibiotic (which is often unnecessary for viral infections).
The 360° holistic care model
To address inconsistent management, this article proposes the 360° holistic care model, focusing on pharmacists as the first line of consultants. This model emphasizes a comprehensive, patient-centred approach that considers not just physical symptoms but also mental well-being and socioeconomic factors.
The model is built on three core concepts:
• Integrative approach: Assessing the whole person, including sleep quality, nutrition and stress, to support faster recovery.
• Multidisciplinary collaboration: Utilizing the expertise of various healthcare providers, with pharmacists playing a key role in providing evidence-based guidance and counteracting misinformation. Pharmacists can also alleviate pressure on primary care services, especially with potential for prescribing for minor ailments.
• Individualized therapy: Tailoring treatment based on the patient’s profile, comorbidities, current stage of the MURTI (early, peak or recovery), and preferences for chemical or natural treatments.
Pharmacist’s stepwise guide
To implement the 360° Holistic Care Model, pharmacists are provided a four-step guide for MURTI management, covering the entire patient journey:
Step 1: Patient Assessment. Collecting patient history, symptoms, and determining the illness stage, while also checking for ‘red flags’ that require referral to a doctor.
2. Step 2: Symptom-Targeted Treatment. Developing a comprehensive plan that includes both pharmacological and non-pharmacological interventions, customized to the patient’s current needs and multiple symptoms.
3. Step 3: Patient Education. Pharmacists educate patients on the safe use of OTC medications (especially high-risk analgesics), potential side effects, and promoting self-care to reduce unnecessary GP visits.
4. Step 4: Patient Follow-up. Structured follow-up enhances adherence and satisfaction. Patients are advised to self-monitor and consult a GP if symptoms worsen or persist for more than 3 weeks.
Treatment options for MURTIs:
• Pharmacological: Includes standard OTC options like analgesics (e.g., paracetamol, ibuprofen) for pain/ fever, decongestants, cough suppressants (antitussives), and antiseptics.
• Phytochemical (plant-based): Many patients prefer natural alternatives, such as essential oils (e.g., eucalyptus), herbal extracts (e.g., ivy leaf, elderberry, propolis), and adaptogens like ginger or ginseng, which can offer a multi-target approach including anti-inflammatory and antiviral effects.
• Non-pharmacological: Involves demulcents (e.g., honey, liquorice) to soothe irritation, saline for nasal hygiene, increasing fluid intake, and preventive measures like hand hygiene and vaccinations (for related viruses like flu). Lifestyle factors such as adequate sleep, stress management, and nutrition are also crucial for supporting immune function and recovery.
This holistic framework aims to empower pharmacists to provide structured, safe and effective care for the vast majority of patients with MURTIs.
Article available at: https://doi.org/10.7573/dic.2025-7-12