Pharmacy Customers Research Articles

Challenges to counseling customers at the pharmacy counter—Why do they exist?

Challenges to engage pharmacy customers in medicine dialogues at the counter have been identified comprising a new and extended clinical role for pharmacists in the health care system. This article seeks to expand understanding of factors involved in successful interaction at the pharmacy counter between customers and pharmacy staff to develop their relationship further. Practical challenges to customer encounters experienced by community pharmacists are discussed using theory from the field of mainly inter-relational communication and particular studies on pharmacy communication. Preconceived expectation of customers, the type of question asked by pharmacy staff, and differences in perception of illness and medicines between staff and customers are discussed. Both staff and customer influence the outcome of attempts by pharmacy staff to engage customers in dialogue about their medicine use through a complex mechanism of interaction. It is recommended that practitioners and researchers begin to distinguish, both theoretically and practically, between the content of a conversation and the underlying relationship when exploring and further developing the therapeutic relationship between pharmacy personnel and customers.

Risky drinking among community pharmacy customers in New Zealand and their attitudes towards pharmacist screening and brief interventions

To estimate the prevalence of risky drinking among customers in community pharmacies and to explore customer attitudes towards screening and brief intervention (SBI). Cross-sectional, anonymous survey, using random selection of community pharmacies in New Zealand to collect data using self-completion questionnaires and an opportunity to enter a prize draw. Participants were customers/patients attending the community pharmacy on a specific, randomly selected day (Monday to Friday) in one set week. Alcohol Use Disorder Identification Test (AUDIT)-C using a cut-off score of 5 was used to measure risky drinking. Attitudes towards pharmacists engaging in SBI for risky drinkers were measured. 2384 completed customer/patient questionnaires from 43 participating pharmacies. Almost 84% ever drank alcohol and using a score of 5 or more as a cut-off, 30% of the sample would be considered as risky drinkers. Attitudes were generally positive to pharmacists undertaking SBI. Logistic regression with AUDIT-C positive or negative as the dependent variable found those taking medicines for mental health and liver disease being more likely to score negative on the AUDIT-C, and smokers and those purchasing hangover cures were more likely than average to have a positive AUDIT-C screen. This study indicates there is scope for community pharmacists to undertake SBI for risky drinking, and that customers find this to be acceptable. Targeted screening may well be useful, in particular for smokers. Further research is required to explore the effectiveness of SBI for risky drinkers in this setting.

Patients' experiences with generic substitution: a Swedish pharmacy survey

Objectives Generic substitution for reimbursed drugs was introduced in Sweden on 1 October 2002. This study aimed to evaluate how Swedish drug consumers experience generic substitution, 5 years after implementation. Methods Pharmacy customers over 18 years of age and presenting a prescription for one of the 2688 included drugs were interviewed. The data were collected at 58 Swedish pharmacies. Outcome measures were perceived difficulties related to generic substitution and their degree of seriousness, potential positive experiences, incidence of reported medication errors and consumers' suggestions for improvements to the system of generic substitution. Key findings Of 1551 respondents (602 male, 949 female), 40% reported at least one difficulty related to substitution, partly resulting in medication errors. A perceived lack of efficacy, a different safety profile and a general confusion regarding the use of generics were the concerns most often reported. Thirty-five per cent (n = 536) reported one or more positive experiences, the most common being the lower drug price. Twenty-two per cent (n = 342) offered suggestions for improvement. The most common suggestions were to revise the criteria for assessing interchangeability between brand name and generic alternatives and to abolish substitution. Conclusion A sizeable minority of respondents experience difficulties related to generic substitution, partly resulting in medication errors. The reported concerns seem to be more frequent within some therapeutic groups, but this finding needs to be studied further. Future system changes should consider the importance of revised criteria for generic and brand-name interchangeability.

A preliminary investigation into customers' perceptions of the image of retail pharmacies in South Africa

AbstractBackgroundThe work scope of retail pharmacists in South Africa has changed considerably over the past few decades. A retail strategy is needed to adapt to these changes and challenges. One of the controllable variables of a retail strategy is store image. For a retail pharmacy, store image consists of factors relating to the pharmacist and factors relating to the pharmacy.ObjectiveThe primary aim of the study was to investigate the image of retail pharmacists and pharmacies in Port Elizabeth, South Africa, in an attempt to supplement knowledge regarding the business aspects of retail pharmacy and to provide a model for a further and more detailed investigation into image research.MethodEmpirical survey consisting of telephone interviews with pharmacy customers. A structured questionnaire was used to investigate the image of pharmacists and pharmacies.SettingThe study was undertaken in Port Elizabeth, South Africa. Two hundred customers from four different pharmacies were selected using systematic random sampling.Key findingsIt was found that pharmacists and pharmacies had an exceptionally favourable image among the general public. The professional element contributed greatly to this positive image.ConclusionThe future will require a delicate balance between the professional and business aspects of retail pharmacy, and this aspect should be investigated further. A more detailed study into customers' perceptions of the image of retail pharmacists and pharmacies is necessary to determine how the image of pharmacy as a profession is changing.

How do pharmacy staff perceive customers who receive an antibiotic?

Abstract The aim of this study was to analyse how two groups of pharmacy staff, one Finnish and one Swedish, perceived video-taped customers who were receiving prescribed antibiotics. The study was based on a model derived from cognitive and interactional psychology. Customers who were presumed to want more extensive drug and health information tended to be regarded as more compliant than other customers. “Independent” customers tended to be regarded as less compliant than other customers. Few differences were found between the results for the Finnish and the Swedish groups, indicating that the professional culture in the two countries is similar. The study found that the pharmacist's judgment of the level of drug compliance is influenced by the pharmacist's metacognitive assumptions regarding the customer's personality and the situation within which the customer acts.

Advice giving in community pharmacies on presentation of NHS prescriptions

Abstract Focal points

Communication and interaction between customers and pharmacy personnel in two Norwegian pharmacies — an observational study

Abstract During the summer of 1993, a social anthropologist carried out non-participating observations in two pharmacies in Oslo, Norway, in order to describe the communication and interaction between the customers and the pharmacy staff. The ways the personnel encountered their customers varied in a striking way. Few indicators could be relied upon in predicting staff behaviour. Informational interaction did occur between customers and staff, but this practice did not seem to be systematic with regard to rules or routines. In the cases of customer-initiated questioning, the customer seemed to be taken good care of. The observations made in this study highlight three important features of pharmacy: a lack of control of admission, the transactional nature of the interaction between customer and staff and a lack of systematic approach for serving customers with particular needs. The quality and content of the information and interaction did not seem to be dependent on the physical layout of the pharmacy. It also seemed more dependent on the personal characteristics of the staff member concerned than on his or her formal competence, and dependent on when, during opening hours, the interaction took place. These features should be taken into account when more standardised routines are implemented for serving pharmacy customers.

In the eyes of the Dunedin public, what constitutes professionalism in medicine?

There has been much debate over the last two decades about professionalism in medicine. Opinions are diverse but, problematically, most are from the academic and medical viewpoints. There is substantially less discourse from the public perspective. To explore the Dunedin public's perspective of important professional qualities in the medical profession. Customers in pharmacies around Dunedin rated 18 different professional qualities on a five-point scale of importance in a self-administered anonymous survey. They also ranked their top five qualities, including their own ideas. Participants rated professional qualities categorised as patient autonomy (mean 4.6) and patient welfare (mean 4.7) of higher importance than qualities categorised as social justice (mean 3.9) and appearance (mean 3.7). Honesty was the top ranked professional quality overall (10.6% of respondents had it in their top five) and the next two top ranked were both concerning patient autonomy (listens carefully and treats you with respect). The most significant difference found between demographic groups and choices was that 53% of people with a highest educational qualification of secondary school or below rated 'accepts a leadership role in the community' as a very important or important quality, compared with 29.4% of people with a post-secondary school qualification (p-value <0.001). This has implications for the current move to make doctors take on more social responsibility within the health care system. It is imperative to have both society and the medical profession aiming for common goals and the challenge of this decade will be striking the balance.

Assessing the acceptability of community pharmacy based pharmaceutical care services in Karachi

Provision of pharmaceutical care services in community pharmacies is a new trend in pharmacy practice worldwide. Published literature from developed countries is available showing benefits of pharmaceutical care services provided in community pharmacies. However, relatively little published literature is available from developing countries in which unique market environments are encountered. This study was conducted to assess the acceptability of community pharmacy based pharmaceutical care services in Karachi. Pharmaceutical care services were developed and offered to pharmacy customers for a period of two months. Acceptability was evaluated with respect to enrollment of participants in the program, discontinuation, and complaints registered. The findings provide a better understanding of pharmaceutical care marketing strategies and are discussed within the context of the health care environment in Karachi.&#x0D; &#x0D; Type: Idea Paper

Estimating problem drinking among community pharmacy customers: what did pharmacists think of the method?

Community pharmacists have successfully been involved in brief interventions in many areas of health, and also provide services to substance misusers. There has been recent interest in community pharmacists providing screening and brief interventions (SBI) to problem drinkers. The aim of this study was to develop a method for measuring prevalence of risky drinking among community pharmacy customers and to explore acceptability of this method to participating pharmacists. Forty-three pharmacies (from 80 randomly selected) in New Zealand agreed to participate in data collection. On a set, single, randomly allocated day during one week, pharmacies handed out questionnaires about alcohol consumption, and views on pharmacists providing SBI, to their customers. At the end of the data collection period semi-structured telephone interviews were carried out with participating pharmacists. Pharmacists were generally positive about the way the study was carried out, the support and materials they were provided with, and the ease of the data collection process. They reported few problems with customers and the majority of pharmacists would participate again. The method developed successfully collected data from customers and was acceptable to participating pharmacists. This method can be adapted to collecting data on prevalence of other behaviours or medical conditions and assessing customer views on services.

Perceptions, use and attitudes of pharmacy customers on complementary medicines and pharmacy practice

BackgroundComplementary medicines (CMs) are popular amongst Australians and community pharmacy is a major supplier of these products. This study explores pharmacy customer use, attitudes and perceptions of complementary medicines, and their expectations of pharmacists as they relate to these products.MethodsPharmacy customers randomly selected from sixty large and small, metropolitan and rural pharmacies in three Australian states completed an anonymous, self administered questionnaire that had been pre-tested and validated.Results1,121 customers participated (response rate 62%). 72% had used CMs within the previous 12 months, 61% used prescription medicines daily and 43% had used both concomitantly. Multivitamins, fish oils, vitamin C, glucosamine and probiotics were the five most popular CMs. 72% of people using CMs rated their products as 'very effective' or 'effective enough'. CMs were as frequently used by customers aged 60 years or older as younger customers (69% vs. 72%) although the pattern of use shifted with older age.Most customers (92%) thought pharmacists should provide safety information about CMs, 90% thought they should routinely check for interactions, 87% thought they should recommend effective CMs, 78% thought CMs should be recorded in customer's medication profile and 58% thought pharmacies stocking CMs should also employ a complementary medicine practitioner. Of those using CMs, 93% thought it important for pharmacists to be knowledgeable about CMs and 48% felt their pharmacist provides useful information about CMs.ConclusionsCMs are widely used by pharmacy customers of all ages who want pharmacists to be more involved in providing advice about these products.

Adverse reactions to complementary medicines: the Australian pharmacy experience

The primary aim was to determine the prevalence of adverse reactions to over-the-counter complementary medicines and their severity, as described by consumers. Secondary aims were to identify consumers' reporting behaviours and understanding of the AUST L designation on product labels. An anonymous, self-administered survey was completed by randomly selected pharmacy customers at 60 community pharmacy locations between August 2008 and February 2009. Of the 1121 survey participants (response rate 62%), 72% had used a complementary medicine product in the previous 12 months, and 7% of this group (n = 55) reported having experienced an adverse reaction at some time. Of these, 71% described the reaction as mild and not requiring treatment, 22% as moderate and/or requiring advice from a healthcare professional and 7% (n = 4) described it as severe and requiring hospitalisation. If they were to report the reaction, it was most commonly to a medical practitioner. Most (88%) of complementary medicine consumers had never noticed the term 'AUST L'. Complementary medicines are widely used by pharmacy customers. Adverse reactions to these products are under-reported to healthcare authorities. Most adverse reactions are mild and serious reactions are rare. Customers have little awareness of the designation AUST L.

Pharmacists' role in improving awareness about folic acid: a pilot study on the process of introducing an intervention in pharmacy practice

Abstract Objective To determine whether a multiple intervention programme to improve women's awareness of folic acid was feasible in community pharmacy practice; to identify adjustments in organisation and materials that could improve feasibility; and to assess how the target group would experience the intervention. Method An action research study was undertaken in which four community pharmacies in the Netherlands participated. In each, a core team (one pharmacist and one to two technicians) was responsible for the organisation and implementation of the intervention. The intervention had several possible levels. As a minimum, pharmacy staff added a label about folic acid to the box of dispensed oral contraceptives (OCs) and handed out a leaflet about folic acid. The intervention was discussed during core team meetings every six weeks. Modifications were made based on the experience of the pharmacy team, on responses from pharmacy customers and on the results of a questionnaire sent to women one week after they visited the pharmacy with an OC prescription. This cycle of planning, action, observation and reflection was repeated twice. Key findings The minimum intervention was carried out by all four pharmacies. Other activities differed: two pharmacies introduced a maximum client age limit for handing out the leaflet; two installed an electronic information display; three worked with posters and window displays; and in two pharmacies the pharmacy technicians wore project badges and an information portfolio was placed in the public area of the pharmacy. Of the target group, 44% were positive about the label, 49% were neutral and 4% were negative. Over half (56%) of the target group stated that they appreciated the public health information given through the pharmacy. Conclusion Working with core teams seemed to be a successful strategy to implement practice change. By discussing and modifying the intervention during each research cycle in the core team meetings, an optimal intervention was reached that fitted in with the existing organisation within the pharmacy and possible barriers were overcome. Feedback from the target group was mainly positive and motivated the core teams to continue.

Consumer attitudes towards community pharmacy services in Saudi Arabia

Abstract Objective The purpose of this study was to determine consumer attitudes towards community pharmacy and their preferences for the introduction of new services. Methods A self-completion questionnaire was developed and 1,144 consumers in 55 community pharmacies were invited to complete it. The questionnaire covered consumers' choice of pharmacy; their perceptions of, and actual interactions with, community pharmacists; advice from pharmacists about general health and prescribed medicines; and privacy in the pharmacy. Respondents were asked for their views about five possible new services. Setting The study was based in community pharmacies in Riyadh City, Saudi Arabia. Key findings The response rate was 79.6%. Fifty-nine per cent of respondents often or sometimes visited a particular pharmacy. One-quarter of respondents perceived community pharmacists as having a good balance between health and business matters, while 56.1% thought pharmacists were more concerned with the business. The majority of respondents (69.7%) said they felt comfortable asking the pharmacist for advice. Just under half (44.8%) felt that pharmacists allowed them enough time to discuss their problem fully and listened well. In addition, 58.5% of respondents indicated that their pharmacists showed sensitivity to privacy by speaking more quietly across the counter. In 14.4% of situations pharmacists were reported to use a private area within the pharmacy when discussing personal or private matters. Most respondents (65.2%) indicated that their pharmacist was willing to discuss their health problems and tried to understand their feelings. Consumers' priorities for new services were: monitoring blood pressure; measuring weight, height and temperature; monitoring blood sugar; and monitoring cholesterol. Conclusion This study showed that most pharmacy customers feel comfortable seeking advice from their pharmacist. Although many pharmacists were reported to show sensitivity to a possible lack of privacy in the pharmacy, few respondents reported that their pharmacy had a private area for discussion. Customers' views on possible new services were generally positive, with the exception of patient medication records.

Interactional issues in the provision of counselling to pharmacy customers

AbstractObjectiveTo investigate issues of manner and politeness in encounters between pharmacy staff and their customers.MethodTwelve surrogate shoppers (research assistants posing as customers) made 360 visits to pharmacies around New Zealand. This paper presents a qualitative analysis of the accounts they gave of these visits.Setting180 community pharmacies throughout New Zealand.Key findingsInteractional issues were important to the shoppers. They expressed a range of concerns about wanting to feel at ease in pharmacies, to feel confident in the quality of counselling, to feel included and to understand the counselling, privacy issues, and wanting to feel genuine concern from the pharmacy staff. Lack of staff attention to these concerns jeopardised the quality of some interactions.ConclusionWe argue that quality interactions are essential conditions for the provision of adequate counselling in pharmacies, and suggest that this is because counselling is not universally accepted as part of pharmacists' role. Pharmacists must make extra efforts to negotiate their role as medication counsellors with customers.

The feasibility of providing community pharmacy-based services for alcohol misuse: A literature review

Abstract Objectives Excessive consumption of alcohol is a major public health concern. The use of community pharmacies and pharmacists as sources of public health information and services is gaining greater recognition. The objective of this review was to provide an overview of the evidence on the feasibility, effectiveness and acceptability of providing community pharmacy-based services to address the excessive consumption of alcohol. Methods Electronic databases were searched for the period 1996–2007 to identify relevant evidence. Searches were also conducted of relevant pharmacy and addiction journals. Information was sought from key contacts in pharmacy and alcohol research. Studies were included if they were conducted in a community pharmacy setting. Key findings The review comprised three feasibility studies which included 14 pharmacies and 500 customers. Non-significant reductions in alcohol consumption were reported with two studies following brief interventions by pharmacists. Between 30% and 53% of pharmacy customers were identified as having hazardous or harmful drinking behaviour. Customer opinion of the pharmacy-based alcohol services was not reported. Conclusions There has been little empirical evaluation of the effectiveness of community pharmacy-based services for alcohol misuse. The evidence presented in this review suggests that community pharmacy-based screening is feasible. Organisations and individuals involved with tackling excessive alcohol consumption should consider the inclusion of community pharmacies and pharmacists as part of their strategies to address this problem. Large-scale studies are needed to evaluate the short- and long-term effects and cost-effectiveness of community pharmacy-based interventions to reduce excessive alcohol consumption, as well as to explore the acceptability of the service to users.

Impact of Medicare Part D on Medicare–Medicaid Dual‐Eligible Beneficiaries' Prescription Utilization and Expenditures

To examine the effect of Part D on 65-78-year-old noninstitutionalized dual eligibles' prescription utilization and expenditures. Random sample of unique pharmacy customers of a national retail pharmacy chain who filled at least one prescription during both 2005 and 2006. For each subject, we obtained claims data for every prescription filled between January 1, 2005, and April 31, 2007. Generalized estimating equations were used to examine the experience of a "treatment" group (dual eligibles between 65 and 78 years on January 1, 2005) with that of a "control" group (near-elderly patients with Medicaid coverage between 60 and 63 years on January 1, 2005) during the first 18 months after Part D implementation. Expenditures for the treatment and control groups tracked each other closely in the pre-Part D period. Immediately following the implementation of Part D, expenditures for both groups decreased and then leveled off. There were no significant changes in trends in the dual eligibles' out-of-pocket expenditures, total monthly expenditures, pill-days, or total number of prescriptions due to Part D. We find no evidence that Part D adversely affected pharmaceutical utilization or out-of-pocket expenditures of dual eligibles during the transition period, nor during the 16 months subsequent to Part D implementation.

Nonadherence to medications among pharmacy clients and their attitude toward medications kept a medicine cabinet at home

To assess self-reported adherence among pharmacy clients and to detect if there are any differences in medication use or storage between genders. The data were collected by means of questionnaires. A standard 45-item questionnaire was developed and used to assess adherence and nonadherence to medications. It was distributed to all pharmacy customers who entered pharmacies chosen by us. Of the 162 (45 men and 117 women) pharmacy clients participating in the study, 36.42% were considered nonadherent. No significant difference in adherence rates between genders was observed (P>0.05). Women more often named themselves as being responsible for a medicine cabinet at home (P<0.001) and used more sources of information on medications (P<0.05). Women also more frequently checked the expiry date of medications in a medicine cabinet home than men (P<0.05). The problem of nonadherence to medications exists among pharmacy clients. There is no significant difference in the rate of self-reported adherence between male and female pharmacy clients. Women are the ones named as responsible for a medicine cabinet at home. They also are important health decision makers. Women are more interested in information on medicines and their use; therefore, this demand should be satisfied.

Building a targeted pharmacy customer engagement approach

PurposeThe purpose of this paper is to elucidate the pathways that can enhance pharmacy‐to‐customer engagements, and give capacity to build closely aligned customer interface systems.Design/methodology/approachA nationwide, pharmacy and customer, dual survey‐based service value networks (SVNs) approach, analysed using structural equation modelling (SEM), shows significant business‐customer encounter information pathways act between the pharmacy and its engaging customer.FindingsThe complex nature of the business‐customer exchange and its interacting pathways is highlighted. Six front‐end SVNs business cells engaged in this paper have significant direct (and/or indirect) impact on customer perspectives of their pharmacy. Hence, the pharmacy front‐end business model should be fully and intelligently networked.Research limitations/implicationsThe SVNs and SEM approach yields a strong robust pharmacy model, and can move pharmacy business management mechanisms to elevated customer‐engaging levels. It can offer customer‐targeted interaction solutions with enhanced perceived satisfaction. This SVNs approach is efficient, understandable, measurable and business specific. It is appropriate for market leaders, innovators or differentiators. Combined with other interface‐related toolkits it can deliver competitive advantage parameters such as understanding the key measures that improve business‐customer alignment.Originality/valueSVNs developed under SEM offer a new way to better align the business with its customers. They can be applied at the individual community pharmacy or pharmacy chain level. SVNs release the key measures from which pertinent interacting front‐end business‐to‐customer pathways may be adjusted in a quest to strategically build and align the business closely to its customer demands. This win‐win SVNs interface procedure can also be applied within other service industries.

Safety of non-prescription medicines: knowledge and attitudes of Italian pharmacy customers

A survey was designed to investigate customers attitudes and knowledge toward non-prescription medicines taken on a self-medication basis but not devoid of risks. Community pharmacies in Italy. Forty-four pharmacies participated in the project. On the basis of an anonymous questionnaire, face-to-face interviews were made to customers buying a non-prescription medicine over a 2-month period. The questionnaire included information about socio-demographic characteristics of the interviewed subjects and 18 items designed to elicit information about the kind of medicine purchased and reason of use, general product knowledge in relation to quality and risks, attitudes toward this kind of drugs, concurrent prescription drug use and the quality of relationship with the pharmacist. During the study period, 613 interviews were collected. The most frequently non-prescription medicines purchased by customers were non-steroidal anti-inflammatory drugs, paracetamol and medicines for gastrointestinal problems. The most of interviewees referred to read carefully the package inserts or to ask information to pharmacists. Moreover, they reported to consider non-prescription medicines easy to manage and to be used only for minor ailments and for short periods. 55.3% of customers reported to have been taking at least a prescription drug, mostly antihypertensives or other cardiovascular medicines, in association with non-prescription medicines. In this situation, interviewees often did not inform pharmacists about chronic therapies. Our interviews demonstrate that, in general, Italian customers have a cautious approach toward non-prescription medicines and are informed on their use. However, in case of a long-term use, interviewees underestimate risks related to possible physiological/pathological changes in their organism or to interactions with other drugs.