Paravattil Bridget, Kheir Nadir, Yousif Adil
Qatar University, Doha, Qatar.
Int J Clin Pharm. 2017 Aug;39(4):759-768. doi: 10.1007/s11096-017-0469-8. Epub 2017 May 2.
Background Patient counseling is one of the most important services a pharmacist can provide to patients. Studies have shown that counseling provided by pharmacists may prevent medication related problems and improve adherence to medication therapy. Objective To explore counseling practices among community pharmacists using simulated patients and to determine if patient, pharmacist, and pharmacy characteristics influence the counseling provided by community pharmacists. Setting Private community pharmacies within Qatar. Method This is a randomized, cross sectional study where simulated patients visited community pharmacies and presented the pharmacist with a new prescription or requested a refill for either a diabetes or asthma medication. Pharmacists completed a questionnaire at the end of the simulated interaction, which was utilized to determine if patient, pharmacist, or pharmacy characteristics had any influence on the counseling provided to patients. A scoring system was devised to assess the pharmacist's counseling practices. Main outcome measure To evaluate the type of information provided by community pharmacists to the simulated patient regarding diabetes and asthma. Results One hundred and twenty-nine pharmacists were enrolled in the study. Eighty one percent of pharmacists had a score <35%. Medication name (95%), directions (47%), indication (43%), and dose (41%) were the most frequently counseled components by pharmacists during the simulated interaction. Male patients received better counseling compared to the female patients (t = 6.177; p < 0.0001). Pharmacists with a master of pharmacy degree provided significantly better counseling (f = 3.261; p = 0.042). Many pharmacists (65%) provided hypoglycemia management to patients, however, 63% referred the patient to the physician when the patient experienced hypoglycemia from inappropriate medication administration. Only 2 (7%) pharmacists correctly counseled the patient on all 8 inhaler administration steps. Majority of pharmacists (50%) educated on the role of the rescue and controller therapy in asthma, however, 33% referred the patient to the physician when the patient inquired about controller therapy use. Conclusion Patient counseling was substandard with the majority of community pharmacists focusing on the name of the medication. Pharmacists rarely assessed patient's medical history or medication use. Disease management and problem solving skills of pharmacists were suboptimal with many referring patients back to the physician.
背景 患者咨询是药剂师能够为患者提供的最重要服务之一。研究表明，药剂师提供的咨询可能会预防与用药相关的问题，并提高药物治疗的依从性。目的 利用模拟患者探讨社区药剂师的咨询实践，并确定患者、药剂师和药房的特征是否会影响社区药剂师提供的咨询。地点 卡塔尔境内的私立社区药房。方法 这是一项随机横断面研究，模拟患者走访社区药房，向药剂师出示新处方或要求为糖尿病或哮喘药物续方。药剂师在模拟互动结束时完成一份问卷，用于确定患者、药剂师或药房的特征是否对向患者提供的咨询有任何影响。设计了一个评分系统来评估药剂师的咨询实践。主要结局指标 评估社区药剂师向模拟患者提供的有关糖尿病和哮喘的信息类型。结果 129名药剂师参与了该研究。81%的药剂师得分<35%。在模拟互动期间，药剂师最常咨询的内容包括药物名称（95%）、用法说明（47%）、适应症（43%）和剂量（41%）。与女性患者相比，男性患者得到了更好的咨询（t = 6.177；p < 0.0001）。拥有药学硕士学位的药剂师提供的咨询明显更好（F = 3.261；p = 0.042）。许多药剂师（65%）向患者提供了低血糖管理，但当患者因用药不当出现低血糖时，63%的药剂师将患者转诊给医生。只有2名（7%）药剂师正确地就吸入器的所有8个使用步骤向患者提供了咨询。大多数药剂师（50%）对哮喘缓解治疗和控制治疗的作用进行了教育，但当患者询问控制治疗的使用时，33%的药剂师将患者转诊给医生。结论 患者咨询水平未达标准，大多数社区药剂师侧重于药物名称。药剂师很少评估患者的病史或用药情况。药剂师的疾病管理和解决问题的技能欠佳，许多人将患者转诊回给医生。
