Community pharmacists' assessments and recommendations for treatment in four case scenarios.

OBJECTIVE

To evaluate community pharmacists' interpersonal skills, ability to make appropriate assessment of a patient' s drug-related problems, and ability to propose an appropriate therapeutic plan.

DESIGN

A disguised shopper design was used. Four different case scenarios were designed, with input from a five-member community/primary care pharmacist advisory committee. Two different cases were assigned to each of two shoppers. One hundred and one pharmacies were shopped twice, totaling 202 shopping experiences. A three-member evaluation committee made up of clinical faculty members in ambulatory care and internal medicine assessed the appropriateness of the recommendations.

SETTING

The study was conducted in 101 randomly selected community pharmacies in the Pittsburgh area, including both chain and independent pharmacies.

MAIN OUTCOME MEASURES

Main outcome measures included the quality of the pharmacists' interpersonal skills, patient assessment skills, and recommendations.

RESULTS

The majority of pharmacists demonstrated acceptable to good interpersonal skills. Overall, 31.7% of the recommendations were appropriate, while 39.1% were poor (i.e., recommendations that would likely worsen the patient's condition or potentially harm the patient). In 33.2% of the cases, recommendations were made without prior assessment of the patient's problems.

CONCLUSIONS

A lack of clinical knowledge and skills should be considered as a barrier that must be overcome if the provision of pharmaceutical care is to become a reality in community practice.