Ibrahim Inas R, Palaian Subish, Ibrahim Mohamed I
Department of Clinical Pharmacy, College of Pharmacy, Uruk University. Baghdad, (Iraq).
Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University. Ajman, (United Arab Emirates).
Pharm Pract (Granada). 2018 Oct-Dec;16(4):1313. doi: 10.18549/PharmPract.2018.04.1313. Epub 2018 Dec 10.
Because community pharmacists are the most accessible healthcare professionals, they are often involved in managing minor ailments within the community setting.
This study evaluated the community pharmacists' history taking practice, medicine dispensing and advice in response to acute diarrhea.
Authors conducted a simulated-patient study in 75 community pharmacies in Baghdad, Iraq from February to May 2015. The female simulated-patient complained of acute diarrhea that had lasted for one day and requested for medicine to treat her condition. After exiting each pharmacy, she then assessed the practices of the community pharmacists through the use of a specially designed checklist adopted with modifications from relevant guidelines. For history taking, a maximum total of eight was the highest obtainable score. Data collected was quantitatively analyzed and Mann-Whitney, Chi-square or Fishers exact tests were used at an alpha level of 0.05.
All of the 75 pharmacies visited were managed by professionally qualified pharmacists. The most common questions asked during history taking were number of diarrheal episodes (n=62; 82.7%); duration of symptoms (n=59; 78.7%) and presence of other diseases and if any drug had been taken (n=58; 77.3%). Female pharmacists had a higher total mean score (6.45, SD=1.33) for history taking when compared to their male counterparts (4.34, SD=2.13); p <0.001. Medicine combination of diphenoxylate HCl 2.5mg + atropine sulphate 0.025mg (n=34; 27.9%) was most frequently dispensed while the least was oral rehydration salt (n=1; 0.8%). Around 20% (n=15) of pharmacists dispensed antimicrobial agents. Over half (n=46; 61.3%) of pharmacists indicated the frequency of use on the medicine packet. Conversely, less than half (n=33; 44.0%) gave any advice on food and fluid intake.
Majority of the community pharmacists asked at least four questions while taking patient history and was very likely to recommend antidiarrheal medicines as first line treatment options. The authors recommend the development of a minimum standard of practice as well as enhanced training for Iraqi community pharmacists.
由于社区药剂师是最容易接触到的医疗保健专业人员，他们经常参与社区环境中轻症疾病的管理。
本研究评估了社区药剂师针对急性腹泻的病史采集实践、药品调配及建议。
2015年2月至5月，作者在伊拉克巴格达的75家社区药房进行了一项模拟患者研究。女性模拟患者主诉急性腹泻持续一天，并请求用药治疗。离开每家药房后，她通过使用一份根据相关指南修改的专门设计的检查表来评估社区药剂师的实践。对于病史采集，最高总分是8分。收集的数据进行了定量分析，使用曼-惠特尼检验、卡方检验或费舍尔精确检验，显著性水平为0.05。
所走访的75家药房均由具备专业资质的药剂师管理。病史采集过程中最常问到的问题是腹泻发作次数（n = 62；82.7%）、症状持续时间（n = 59；78.7%）以及是否存在其他疾病和是否服用过任何药物（n = 58；77.3%）。女性药剂师在病史采集方面的总平均分（6.45，标准差 = 1.33）高于男性药剂师（4.34，标准差 = 2.13）；p < 0.001。最常调配的药物组合是盐酸地芬诺酯2.5毫克 + 硫酸阿托品0.025毫克（n = 34；27.9%），而最少调配的是口服补液盐（n = 1；0.8%）。约20%（n = 15）的药剂师调配了抗菌药物。超过一半（n = 46；61.3%）的药剂师在药包上标明了使用频率。相反，不到一半（n = 33；44.0%）的药剂师就食物和液体摄入给出了任何建议。
大多数社区药剂师在采集患者病史时至少问了四个问题，并且很可能推荐止泻药作为一线治疗选择。作者建议为伊拉克社区药剂师制定最低实践标准并加强培训。
