Abstract
ObjectivesTo assess the management of requests for information about a prescription only medicine (simvastatin for treatment of dyslipidemia) by pharmacy staff in community settings and explore the factors influencing the information content.MethodsA cross sectional study conducted using the stimulated patient (SP) method between November 2018 and May 2019. The SP conveyed the request at the beginning of the encounter in a standardized way based on predetermined plots and was instructed to ask the pharmacy staff directly if information was not discussed spontaneously. After the visit, the SP provided written feedback including information about the scenario and a copy of individualized feedback. The study was reported according to the checklist for reporting research using simulated patient methodology (CRiSP). Factors influencing information content with or without information demand were investigated.ResultsA total of 55 visits were analyzed. The average content score for the information discussed spontaneously was 16.2% with the standard deviation (SD) equal to15.6. The score improved significantly after information was demanded by the SP; the average total information content score became 34.4% (SD = 16) with p < 0.001. The score of information discussed spontaneously was higher for male pharmacy staff, older age, more experience, and a Pharm D degree. When the SP prompted or demanded for information, older pharmacy staff with more experience and with a college degree scored higher. Independent pharmacies, longer visit durations, and less distraction were associated significantly with higher information scores Pharmacy staff aged 35–39 and those with 6–10 years of experience were significant contributors to spontaneous discussion of information with p values = 0.003 and 0.013, respectively. After the SP demanded information, pharmacy staff with less than 5 years of experience and greater confidence as well as longer visits were positively predicting higher information scores with p values of 0.049, 0.04, and 0.04, respectively.ConclusionsInformation provided by community pharmacists responding to information requests about prescription only medications was found to be suboptimal. Patient requests for information were found to be a positive driver for better information content. Further research of mixed methodologies is required to clarify the factors and motivators enabling information exchange in community settings and to outline true training needs.
Highlights
Community pharmacies are the most accessible health care venue for patient counseling
The score improved significantly after information was demanded by the simulated patient (SP); the average total information content score became 34.4% (SD = 16) with p < 0.001
The score of information discussed spontaneously was higher for male pharmacy staff, older age, more experience, and a Pharm D degree
Summary
Community pharmacies are the most accessible health care venue for patient counseling. With increased access to medications and information, the key roles for community pharmacists in rationalizing medication use are growing [1]. It is important to outline ways to support community pharmacists in their roles of changing patients’ life styles, reinforcing medication adherence, simplifying dosage regimens, and communicating with patients to establish the desired therapeutic outcomes [3, 6]. The simulated patient (SP) approach is widely used to assess practice assessment since it captures a spontaneous observation without individuals being aware of being evaluated [7]. It is useful in enforcing improvements by guiding focused and tailored feedback in natural practice settings [8, 9]
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