Response of community pharmacists to the presentation of back pain: a simulated patient study

Abstract

Abstract Objective To assess the response of community pharmacists to the presentation of back pain. Method The researcher posed as a customer to obtain medication for back pain for her grandfather, and the consultations were recorded in a pretested data collection form. Setting The study was conducted in 100 randomly selected community pharmacies located within the Klang Valley in Malaysia. This includes Kuala Lumpur, the capital city of Malaysia and its surrounding suburban areas. Key findings In 85% of the consultations, pharmacists asked at least one question before recommending a treatment. The patient's medical history was the most frequently asked question by the pharmacists (60%). In general, a median of only five counselling elements were addressed by the pharmacists out of 13 recommended. The most common element of counselling addressed was the route of administration (98%), followed by the frequency and dose to be taken (92% and 88%, respectively). None of the pharmacists asked the ‘customer’ whether she required any further information. The number of counselling elements addressed was significantly associated with the age of the pharmacist, duration of consultation and the types of medication recommended (P < 0.05). Most of the pharmacists (88%) recommended at least an oral non-steroidal anti-inflammatory drug or a selective cyclooxygenase-2 inhibitor for the treatment of acute back pain. Diclofenac was the most commonly recommended medication for back pain (55% of consultations), followed by meloxicam (15%). The cost of treatment for back pain ranged from RM2.00 to RM38.00 with a median of RM10.00. Conclusion This study demonstrates that the extent of information gathering and counselling varied among community pharmacists in Malaysia and that in general, this appeared to be suboptimal. Professional bodies such as the Malaysian Pharmaceutical Society should create awareness among pharmacists regarding their responsibility to counsel patients or their caregivers.