Assessment of community pharmacists’ counselling skills on headache management by using the simulated patient approach: a pilot study
Background: Headache, or cephalalgia, is one of the 20 most disabling diseases in the world and affects a large portion of the world’s population. People generally use over-the-counter medications to treat headaches and other minor symptoms. A pharmacist should help patients choose the most effective, safe, and convenient pharmacotherapeutic option.
Objective: To assess the counselling skills of community pharmacists for headache management by using the simulated patient approach.
Methods: A cross-sectional study was conducted from March 2010 to July 2010. Data were obtained from a convenience sample consisting of one pharmacist from each of the 24 participating community pharmacies. In order to evaluate the pharmacists’ counselling skills, a simulated patient role played a standardized headache case requesting self-medication. The interactions of the simulated patient with the pharmacists were audiovisually recorded using a hidden micro camera, and these recordings were analysed using a validated questionnaire.
Results: Of the 24 evaluated pharmacists, 19 (79.1%) were women. Information was spontaneously provided by 15 (62.5%) pharmacists. At least one question was asked by the pharmacist to assess the signs and symptoms. Most pharmacists (n=17, 70.8%) recommended sodium dipyrone, either alone or in combination with other drugs. The most discussed items in the simulation visits were contraindications (n=17, 70.8%), indications (n=10, 41.6%), and drug administration times (n=8, 33.3%). None of the pharmacists recommended any non-pharmacological therapeutic alternatives. The overall impressions of the pharmacists’ professional counselling skills ranged from poor to fair.
Conclusion: This study showed that the pharmacists’ counselling skills and the guidance provided by the pharmacists to the simulated patient were insufficient for the satisfactory management of headache.
2. Gahir KK, Larner AJ. What role do community pharmacists currently play in the management of headache? A hospital-based perspective. Int J Clin Pract. 2004;58(3):257-9.
3. Steiner TJ, MacGregor EA, Davies PT. Guidelines for all healthcare professionals in the diagnosis and management of migraine, tension-type, cluster and medication-overuse headache writing committee. 3rd edition; approved for publication, 18 January 2007.
4. Franco ML, Seoane de Lucas A. [Characteristics of chronic pain in the elderly: treatment.] Rev Soc Esp Dolor 2001;8:29-38. Available at http://revista.sedolor.es/pdf/2001_01_05.pdf
5. Alonzo HGA, Cristiana L, Corrêa CL, Zambrone FAD. [Analgesics, antipyretics and non-steroidal anti-inflammatory drugs: epidemiological data on six intoxication control centers in Brazil.] Rev Bras Toxicol. 2001;14:49-54.
6. WHO. The role of the pharmacist in self- care and self-medication. The Hague: Report of a WHO Consultive. 26-28 August 1998.
7. Porteous T, Ryan M, Bond CM, Hannaford P. Preferences for self-care or professional advice for minor illness: a discrete choice experiment. Br J Gen Pract. 2006;56(533):911-7.
8. Smiley T. The role of the pharmacist in identification, referral, and management of migraine headache. CE Compliance Centre National Continuing Education Program 2005.
9. Berger K, Eickhoff C, Schulz M. Counselling quality in community pharmacies: implementation of the pseudo customer methodology in Germany. J Clin Pharm Ther. 2005;30(1):45-57.
10. Benrimoj SI, Werner JB, Raffaele C, Roberts AS, Costa FA. Monitoring quality standards in the provision of nonprescription medicines from Australian Community Pharmacies: results of a national programme. Qual Saf Health Care. 2007;16(5):354-8.
11. McDonough P, Bennett MS. Improving communication skills of pharmacy students through effective precepting. Am J Pharm Educ. 2006;70(3):58.
12. Boal A. [Theatre of the oppressed and others poetics policies.] 8th ed. Rio de Janeiro: Civilização Brasileira, 2008.
13. Boal A. [Games for actors and non-actors.] 12th ed. Rio de Janeiro: Civilização Brasileira, 2008.
14. Mesquita AR, Santos EA, Porto JG, Barros IM, Lyra Jr DP. Translation in Brazilian Portuguese and content validation of the questionnaire “Avaliação do Processo de Atendimento Farmacêutico”. Acta Farmacéutica Bonaerense 2012;31:1422-9.
15. Wertheimer AI, Serradell J. A discussion paper on self-care and its implications for pharmacists. Pharm World Sci. 2008;30(4):309-15. doi: 10.1007/s11096-007-9187-y
16. Yousef AM, Al-Bakri AG, Bustanji Y, Wazaify M. Self-medication patterns in Amman, Jordan. Pharm World Sci. 2008;30(1):24-30.
17. Sanvito WL, Monzillo PH. [Primary headaches: clinical and therapeutic aspects.] Medicina, Ribeirão Preto. 1997;30:437-48.
18. Brazil. Law nº 6.437, of August 20, 1977. [Sets violations of federal health legislation, establishes the respective sanctions, and others arrangements]. Brasília, DF, 24 Aug. 1977.
19. Knappmann AL, Melo EB. [Quality of over the counter drugs: a study of dipyrone brands marketed in a drugstore on Cascavel (PR, Brazil).] Cienc Saude Coletiva. 2010;15(3):3467-3476. doi: 10.1590/S1413-81232010000900021
20. Risks of agranulocytosis and aplastic anemia. A first report of their relation to drug use with special reference to analgesics. The International Agranulocytosis and Aplastic Anemia Study. JAMA. 1986;256(13):1749-57.
21. Toklu HZ, Dülger GA, Hidiroglu S, Akici A, Yetim A, Gannemoglu HM, Günes H. Knowledge and attitudes of the pharmacists, prescribers and patients towards generic drug use in Istanbul – Turkey. Pharm Pract. 2012;10(4):199-206.
22. National Council of Education. [National guidance for the undergraduate teaching of Pharmacy], Brazil 2002. Oficial Gazette: Brasília. 2002;1:9.
23. Fernandes ZC, Bermond MD, de Oliveira Filho NCF, Camargo EES, Cecy C. [The challenges of pharmaceutical education in Brazil]. Brasília: Federal Council of Pharmacy, 2008.
24. Aslani P, Benrimoj SI, Krass I. Development and evaluation of a training program to foster the use of written drug information in community pharmacies: part 1–development. Pharm Educ . 2006;6(1):41-52.
25. de Almeida Neto AC, Benrimoj SI, Kavanagh DJ, Boakes RA. Novel educational training program for community pharmacists. Am J Pharm Educ. 2000;64:302-7.
The authors hereby transfer, assign, or otherwise convey to Pharmacy Practice: (1) the right to grant permission to republish or reprint the stated material, in whole or in part, without a fee; (2) the right to print pr epublish copies for free distribution or sale; and (3) the right to republish the stated material in any format (electronic or printed). In addition, the undersigned affirms that the article described above has not previously been published, in whole or part, is not subject to copyright or other rights except by the author(s), and has not been submitted for publication elsewhere, except as communicated in writing to Pharmacy Practice with this document.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY-NC-ND) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.