Alte Dietrich, Weitschies Werner, Ritter Christoph A
Institute of Epidemiology and Social Medicine, Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Germany.
Ann Pharmacother. 2007 Jun;41(6):1023-30. doi: 10.1345/aph.1H565. Epub 2007 May 22.
Consultation of patients in community pharmacies (CPs) must meet standards, especially in selling over-the-counter drugs; however, there has been no information as to whether northeastern German CPs meet these standards.
To estimate aspects of consultation quality in CPs in Mecklenburg-Vorpommern, located in northeastern Germany, study factors related to consultation quality, and check compliance with Pharmacy Practice Law, because not all pharmaceutical professions may legally sell drugs.
In 2005, 6 mystery shoppers (pharmacy students) presented with a headache to 146 of 398 CPs; they requested a sleeping pill plus an antihistaminic drug and completed data collection forms. Consultation scores were calculated and effects of pharmacy/staff characteristics on consultation were modeled with linear (consultation score) and logistic regression (failure to detect a drug-drug interaction). Variables used in models were staff profession, pharmacy size (number of staff), city/town size (number of pharmacies), and day of the week in which shoppers visited the pharmacy.
Despite a high willingness of pharmacy staff to provide consultation (83% spontaneously offered advice), northeastern German CPs did not achieve their professional mission. Extreme variation was evident in their questioning of the mystery shoppers regarding use of important single items (from 1% for pregnancy/breast-feeding considerations to 56% for dosing instructions). In all cases, drugs were sold to the shoppers; most (91%) were single agents. Drug-drug interaction detection was low: 43 (30%) counselors informed mystery shoppers about the interaction. The profession of the consulting staff and the size of the pharmacy were associated with consultation quality (highest for pharmacists; lowest for small pharmacies [2-4 staff]). For interaction detection, consulting staff profession was relevant: pharmacists had OR of 3.2 for the detection compared with pharmacy engineers/assistants. In 7 pharmacies, staff illegally sold drugs to customers.
Northeastern German CPs have much need and potential for improvement in consultation quality and drug-drug interaction detection. In-depth elicitation of symptoms and details of patients' situations must be improved. Relevant training should be provided, including use of software to identify drug interactions. Mystery shopper studies give valuable information for tailoring training schemes.
社区药房对患者的咨询必须符合标准，尤其是在销售非处方药方面；然而，关于德国东北部的社区药房是否符合这些标准，尚无相关信息。
评估位于德国东北部的梅克伦堡-前波美拉尼亚州社区药房的咨询质量方面，研究与咨询质量相关的因素，并检查是否符合《药房实践法》，因为并非所有药学专业人员都有合法售药资格。
2005年，6名神秘顾客（药学专业学生）向398家社区药房中的146家诉说有头痛症状；他们索要一片安眠药加一种抗组胺药，并填写数据收集表。计算咨询得分，并使用线性回归（咨询得分）和逻辑回归（未发现药物相互作用）对药房/工作人员特征对咨询的影响进行建模。模型中使用的变量包括工作人员职业、药房规模（工作人员数量）、城镇规模（药房数量）以及神秘顾客光顾药房的星期几。
尽管药房工作人员提供咨询的意愿很高（83%的人主动提供建议），但德国东北部的社区药房并未完成其专业使命。在询问神秘顾客关于重要单项使用情况方面存在极大差异（从怀孕/哺乳考虑的1%到给药说明的56%）。在所有情况下，都向顾客出售了药品；大多数（91%）是单一药物。药物相互作用的检测率很低：43名（30%）咨询人员告知了神秘顾客药物相互作用的情况。咨询工作人员的职业和药房规模与咨询质量相关（药剂师的咨询质量最高；小药房[2 - 4名工作人员]的最低）。对于相互作用检测，咨询工作人员的职业很重要：与药房工程师/助理相比，药剂师检测出相互作用的比值比为3.2。在7家药房中，工作人员非法向顾客售药。
德国东北部的社区药房在咨询质量和药物相互作用检测方面有很大的改进需求和潜力。必须改进对患者症状和情况细节的深入询问。应提供相关培训，包括使用软件识别药物相互作用。神秘顾客研究为定制培训方案提供了有价值的信息。
