Faculty of Pharmacy, University of Sydney, Pharmacy Building (A15), Sydney, NSW, 2006, Australia.
Int J Clin Pharm. 2011 Apr;33(2):237-45. doi: 10.1007/s11096-011-9482-5. Epub 2011 Mar 12.
It is known that many people with insomnia choose to self medicate and present at community pharmacies, particularly in cases of acute insomnia. The objective of this study is to investigate how community pharmacists respond to complaints of acute insomnia from people who seek self treatment and determine the factors affecting this response.
Community pharmacies in New South Wales, Australia.
A simulated patient study was conducted in 100 randomly selected pharmacies located in Newcastle and Sydney, Australia. A standardized scenario of acute sleep onset insomnia and a scoring system was used in each pharmacy.
Main outcome measures included supply/non supply of an over the counter sleep aid to the simulated patient, and scores for pharmacists for skills in eliciting information prior to supply of medication (Pre Supply Score), counseling about medication (Supply Score), or about sleep (Sleep Score).
Of the 100 pharmacies, upon simulated patient presentation, 96% supplied a product, the remaining 4% referred to a physician. Non-pharmacological advice was provided in 42%. Pharmacists scored highly on advice provided with supply of a medication (Supply scores/4, 3.1 ± 0.9), but lower on skills in eliciting information prior to supply (Pre-supply score/8, 3.6 ± 1.9) and sleep related counselling (Sleep Score/9, 2.1 ± 1.7). Lower estimated pharmacist age, being in a chain type pharmacy, and having a visible symbol of quality accreditation were found to significantly improve (P < 0.05 the Sleep Score outcome. Lower estimated pharmacist age as also significantly associated with higher Supply Score (P < 0.05); whilst both lower estimated age an visible quality assurance signage were associated with higher Pre-Supply scores (P < 0.05).
The results of this study suggest that many pharmacists are responding appropriately to complaints of sleeplessness in terms of eliciting insomnia type and counseling about medicines use. However more education for pharmacists would help to further promote good sleep health, and address behaviors including reliance on medicines taking that can progressively worsen insomnia.
众所周知，许多失眠患者选择自我治疗，并在社区药店就诊，尤其是在急性失眠的情况下。本研究旨在调查社区药剂师如何应对寻求自我治疗的急性失眠患者的投诉，并确定影响这种反应的因素。
澳大利亚新南威尔士州的社区药店。
在澳大利亚纽卡斯尔和悉尼的 100 家随机选择的药店进行了模拟患者研究。在每家药店都使用了急性睡眠发作失眠的标准化场景和评分系统。
主要观察指标包括向模拟患者提供非处方助眠药物的供应/不供应，以及药剂师在提供药物之前获取信息的技能评分（供应前评分）、药物咨询评分（供应评分）或睡眠咨询评分（睡眠评分）。
在 100 家药店中，有 96%的药店在模拟患者就诊时提供了产品，其余 4%的药店推荐患者去看医生。有 42%的药店提供了非药物建议。药剂师在提供药物时提供的建议得分较高（供应得分/4，3.1±0.9），但在提供药物前获取信息的技能评分（供应前评分/8，3.6±1.9）和与睡眠相关的咨询评分（睡眠评分/9，2.1±1.7）较低。发现估计药剂师年龄较低、在连锁店型药店工作以及有可见的质量认证标志，与睡眠评分结果显著提高（P<0.05）有关。估计药剂师年龄较低也与供应得分较高显著相关（P<0.05）；而估计年龄较低和可见的质量保证标志都与供应前得分较高相关（P<0.05）。
本研究结果表明，许多药剂师在缓解失眠投诉方面做出了适当的反应，包括确定失眠类型和咨询药物使用。然而，对药剂师进行更多的教育将有助于进一步促进良好的睡眠健康，并解决包括依赖药物治疗在内的行为，这些行为可能会逐渐加重失眠。
