Mobark Dalal M, Al-Tabakha Moawia M, Hasan Sanah
College of Pharmacy & Health Sciences, Ajman University. Ajman (United Arab Emirates).
Department of Pharmaceutical Sciences, College of Pharmacy & Health Sciences, Ajman University. Ajman (United Arab Emirates).
Pharm Pract (Granada). 2019 Apr-Jun;17(2):1465. doi: 10.18549/PharmPract.2019.2.1465. Epub 2019 Jun 11.
Hormonal contraceptive pills have evolved as a common form of contraception worldwide. Pharmacists play a vital role in providing safe and effective access to these medicines. In many developing countries such as the United Arab Emirates (UAE), these medicines are available to the general public without the presentation of a prescription which requires the pharmacist to shoulder responsibility by assessing and educating patients to assure their appropriate use.
To evaluate community pharmacists' current practice of dispensing and counseling on hormonal contraceptives.
Simulated patient methodology was used in this study. A single simulated patient visited community pharmacies requesting an oral contraceptive as per a preplanned scenario. Information from the visits were recorded on a data collection form including: pharmacist assessing patient eligibility to take hormonal contraceptives, selecting the appropriate oral contraceptive, providing complete counseling on how to use the pill, adherence, missed dose handlings and side effects of the medication. The Pharmacist was prompted by the simulated patient to provide the information if they did not provide spontaneous counseling. The quality of pharmacists' counseling was rated and consequently coded as complete, incomplete or poor.
A total of 201 community pharmacies were visited. More than 92% of the pharmacists did not ask the simulated patient any question to assess their eligibility to use contraceptives. Twenty three pharmacists (11.4%) selected the proper product. One hundred seventeen (58.2%) of the pharmacists provided spontaneous counseling on how to use the pill, 17 of them had their counsel rated as complete, but none of the pharmacists provided spontaneous counseling regarding adherence or side effects of the medications. On prompting, 10 pharmacists (12%) provided complete counseling regarding how to use oral contraceptives, 14 pharmacists (7.0%) provided complete counseling on adherence and missing dose handling and five pharmacists (2.5%) provided complete counseling about expected side effects.
Pharmacists' practice regarding hormonal contraceptive dispensing and counseling was suboptimal in this study. Areas needing intervention were related to pharmacist assessment of eligibility for oral contraceptive use, choice of optimal oral contraceptive for patient-specific co-morbidities and provision of adequate counseling regarding proper use, adherence and missed dose handlings.
激素避孕药已成为全球一种常见的避孕方式。药剂师在确保这些药物的安全有效使用方面发挥着至关重要的作用。在许多发展中国家，如阿拉伯联合酋长国（阿联酋），这些药物无需处方即可向公众提供，这就要求药剂师通过评估和教育患者来承担责任，以确保他们正确使用药物。
评估社区药剂师在激素避孕药调配和咨询方面的当前做法。
本研究采用模拟患者方法。一名模拟患者按照预先设定的场景前往社区药房索要口服避孕药。访视信息记录在数据收集表上，包括：药剂师评估患者服用激素避孕药的资格、选择合适的口服避孕药、就如何服用药物、依从性、漏服处理及药物副作用提供完整咨询。如果药剂师没有主动提供咨询，模拟患者会提示他们提供相关信息。药剂师咨询的质量被评级，并相应编码为完整、不完整或差。
共走访了201家社区药房。超过92%的药剂师没有向模拟患者询问任何问题以评估其使用避孕药的资格。23名药剂师（11.4%）选择了合适的产品。117名药剂师（58.2%）主动就如何服用药物提供了咨询，其中17人的咨询被评为完整，但没有药剂师主动就药物的依从性或副作用提供咨询。在提示下，10名药剂师（12%）就如何服用口服避孕药提供了完整咨询，14名药剂师（7.0%）就依从性和漏服处理提供了完整咨询，5名药剂师（2.5%）就预期副作用提供了完整咨询。
在本研究中，药剂师在激素避孕药调配和咨询方面的做法并不理想。需要干预的领域涉及药剂师对口服避孕药使用资格的评估、针对患者特定合并症选择最佳口服避孕药以及就正确使用、依从性和漏服处理提供充分咨询。
