Evaluation of simulated drug dispensing and patient counseling in the course of pharmaceutical improvement: 2009 to 2015
Background: Aiming to facilitate the drug dispensing process and patient counseling, specific professional skills are required. The knowledge, skills and attitudes involved in this process can be improved. From 2012 to 2015, a nationwide course was held, in partnership with the Ministry of Health and the Federal University of Rio Grande do Sul (UFRGS) – Brazil, to train pharmacists working in primary health care through the development of their clinical and communication skills. One of the steps in this process involved the simulation of the drug dispensing process and patient counseling.
Objective: To evaluate the performance of pharmacists in drug dispensing and counseling through patient simulation role-playing held in a face-to-face meeting at the end of a training course.
Methods: A cross-sectional and retrospective study with analysis of patient simulation recordings and data collection using an assessment instrument with scores ranging from 0 to 10 points to assess pharmacist's behavior, skills, and technical knowledge.
Results: Participants presented poor-to-regular performance, with median scores equal to or lower than six. The median time of the drug dispensing simulation was five minutes and the patient counseling was eight minutes. Pharmacists had better scores in the simulation of asthma cases. In drug dispensing, 99.5% of pharmacists had difficulty checking the patient's time availability, 98.5% did not know how to use the devices, and 94.7% did not advise the patient on what to do if they forgot to take a dose. In patient counseling simulation, 1.18% of pharmacists remembered to advise on what do with medication leftovers, and 50.6% asked questions that induced the patient's responses.
Conclusions: The low-to-regular performance showed that pharmacists had difficulties at improving their skills in the performance of complete and effective drug dispensing and patient counseling.
Possamai FP, Dacoreggio MS. [The skill of communicating with the patient in the pharmaceutical care process]. Trab Educ Saude. 2008;5(3):473-490. https://doi.org/10.1590/S1981-77462007000300008
Palhano T. [Pharmacist-led patient counseling]. Infarma. 1992;1(1): 5-7.
Oenning D, Oliveira BV, Blatt CR. Conhecimento dos pacientes sobre os medicamentos prescritos após consulta médica e dispensação [Patient awareness about drugs prescribed after medical appointment and prescription]. Cien Saude Colet. 2011;16(7):3277-3283. https://doi.org/10.1590/s1413-81232011000800027
Galato D, Alano GM, Trauthman SC. Vieira AC. [The dispensation of medicines: a reflection for prevention, identification and solution of drug related problems]. Rev Bras Ciencias Farm. 2008;44(3):465-475. https://doi.org/10.1590/S1516-93322008000300017
Smithson J, Bellingan M, Glass B. Mills J. Standardized patients in pharmacy education: An integrative literature review. Curr Pharm Teach Learn. 2015;7(6):851-863. https://doi.org/10.1016/j.cptl.2015.08.002
Björnsdottir I, Granas AG, Bradley A, Norris P. A systematic review of the use of simulated patient methodology in pharmacy practice research from 2006 to 2016. Int J Pharm Pract. 2020;28(1):13-25. https://doi.org/10.1111/ijpp.12570
McDonough RP, Bennett MS. Improving communication skills of pharmacy students through effective precepting. Am J Pharm Educ. 2006;70(3):58. https://doi.org/10.5688/aj700358
Pohjanoksa-Mäntylä, Puumalainen I, Marja Airaksinen M. Counselling, Concordance and Communication – Innovative Education for Pharmacists. The Hague: FIP; 2012.
Kerr A, Strawbridge J, Kelleher C, Mertens F, Pype P, Deveugele M, Pawlikowska T. How can pharmacists develop patient-pharmacist communication skills? A realist review protocol. Syst Rev. 2017;6(1):14. https://doi.org/10.1186/s13643-016-0396-0
Limberger JB. [Active teaching-learning methodologies for pharmaceutical education: a report on experience]. Interface. 2013;17(47), 969-975. https://doi.org/10.1590/1807-57622013.3683
Macleod-glover N. Communication in Pharmacy Practice : An Overview. Available at: https://www.tevacanada.com/globalassets/canada-ph2/pdf-documents-en/archived-ces/practice-ces/0606_practice-ce_communication-in-pharmacy_en.pdf (accessed Mar 1, 2020).
Silva MJ. [Comunication has a solution: Comunication in interpersonal relations]. Sao Paulo: Loyola;2010. ISBN: 9788515025534.
Devraj R, Butler LM, Gupchup GV, Poirier TI. Active-learning strategies to develop health literacy knowledge and skills. Am J Pharm Educ. 2010;74(8):137. https://doi.org/10.5688/aj7408137
Mesquita AR, Souza WM, Boaventura TC, Barros IM, Antoniolli AR, Silva WB, Lyra Júnior DP. The effect of active learning methodologies on the teaching of pharmaceutical care in a Brazilian pharmacy faculty. PLoS One. 2015;10(5):e0123141. https://doi.org/10.1371/journal.pone.0123141
Hermida PM, Barbosa SS, Heidemann IT. [Active methodology in nursing education: innovation of the practice in the primary health care]. Rev Enferm UFSM. 2015;5, 1–9. https://doi.org/10.5902/2179769216920
Roman, C. Ellwanger J, Becker GC, Silveira AD, Bezerra Machado CL, Manfroi WC. [Learning and teaching active learning methods in the Brazilian traching process]. Clin Biomed Res. 2017;37(4):349-357.
Gaba DM. The future vision of simulation in healthcare. Simul Healthc. 2007;2(2):126-135. https://doi.org/10.1097/01.sih.0000258411.38212.32
Regan K, Harney L, Goodhand K, Strath A, Vosper H. Pharmacy Simulation: A Scottish, Student-Led Perspective with Lessons for the UK and Beyond. Pharmacy (Basel). 2014;2:50-64.
Rabelo L, Garcia VL. Role-play for the development of communication skills. Rev Bras Educ Med. 2015;39, 586-596.
Oliveira KC, Cavalcanti RC, Brito BR, Pimentel TS, Lima AX. Implementação da técnica role-play como estratégia metodológica para ensino do processo de enfermagem: relato de experiência. Available at: https://www.esenfc.pt/event/event/abstracts/exportAbstractPDF.php (accessed Mar 1, 2020).
Mesquita AR, Lyra DP Jr, Brito GC, Balisa-Rocha BJ, Aguiar PM, de Almeida Neto AC. Developing communication skills in pharmacy: a systematic review of the use of simulated patient methods. Patient Educ Couns. 2010;78(2):143-148. https://doi.org/10.1016/j.pec.2009.07.012
Jeffries PR. A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nurs Educ Perspect. 2005;26(2):96-103.
UFRGS. [Improvement course: Pharmacists in primary healthcare]. Available at: http://www.ufrgs.br/farmaceuticosabemrede (accessed Mar 1, 2020).
Beardsley R, Kimberlim C, Tindall W. Communication skills in pharmacy practice. Philadelphia: Lippincott Williams & Wilkins; 2011. ISBN-13: 978-1608316021
Berger B. Habilidades de comunicação para farmacêuticos: construindo relacionamentos, otimizando o cuidado aos pacientes. Sao Paulo: Pharmabook; 2011. ISBN: 978-8589731546
Reis TM, Guidoni CM, Girotto E, Rascado RR, Mastroianni PC, Cruciol JM, Pereira LR. Knowledge and conduct of pharmacists for dispensing of drugs in community pharmacies: a cross-sectional study. Brazilian J Pharm Sci. 2015;51(3):733-744. https://doi.org/10.1590/S1984-82502015000300025
Departamento de Assistência Farmacêutica e Insumos Estratégicos. [Pharmaceutical care in primary healthcare] Brasilia: Ministerio da Saude; 2015.
Pereira LR, Freitas O. [Evolution of pharmaceuytical care and the Brazilian perspective]. Rev Bras Ciencias Farm. 2008;44:601-612.
Paravattil B, Kheir N, Yousif A. Utilization of simulated patients to assess diabetes and asthma counseling practices among community pharmacists in Qatar. Int J Clin Pharm. 2017;39(4):759-768. https://doi.org/10.1007/s11096-017-0469-8
Murphy AL, Gardner DM. A simulated patient evaluation of pharmacist's performance in a men's mental health program. BMC Res Notes. 2018;11(1):765. https://doi.org/10.1186/s13104-018-3869-5
Obreli-Neto PR, Pereira LR, Guidoni CM, de Oliveira Baldoni A, Marusic S, de Lyra-Júnior DP, de Almeida KL, Pazete AC, do Nascimento JD, Kos M, Girotto E, Cuman RK. Use of simulated patients to evaluate combined oral contraceptive dispensing practices of community pharmacists. PLoS One. 2013;8(12):e79875. https://doi.org/10.1371/journal.pone.0079875
Clayton K, Luxford Y, Colaci J, Hasan M, Miltiadou R, Novikova D, Vlahopoulos D, Stupans I. Community pharmacists' recommendations for natural products for stress in Melbourne, Australia: a simulated patient study. Pharm Pract (Granada). 2020;18(1):1660. https://doi.org/10.18549/pharmpract.2020.1.1660
Zolezzi M, Abdallah O, Kheir N, Abdelsalam AG. Evaluation of community pharmacists' preparedness for the provision of cardiovascular disease risk assessment and management services: A study with simulated patients. Res Social Adm Pharm. 2019;15(3):252-259. https://doi.org/10.1016/j.sapharm.2018.04.032
Elayeh ER, Hammad EA, Tubeileh RH, Basheti IA. Use of secret simulated patient followed by workshop based education to assess and improve inhaler counseling in community pharmacy in Jordan. Pharm Pract (Granada). 2019;17(4):1661. https://doi.org/10.18549/pharmpract.2019.4.1661
Yaacoub SG, Koyess V, Lahoud N, Lahoud N, Rahme D, Francis N, Saleh N, Maison P. Antibiotic prescribing for acute uncomplicated cystitis in Lebanese community pharmacies using a simulated patient. Pharm Pract (Granada). 2019;17(4):1604. https://doi.org/10.18549/pharmpract.2019.4.1604
Oh Y, McCombs JS, Cheng RA, Johnson KA. Pharmacist time requirements for counseling in an outpatient pharmacy. Am J Health Syst Pharm. 2002;59(23):2346-2355. https://doi.org/10.1093/ajhp/59.23.2346
De Castro LT, Couto TB. Rapid cycle deliberate practice: A modern simulation strategy. Sci Med (Porto. Alegre). 2018;28(1):28849. https://doi.org/10.15448/1980-6108.2018.1.28849
Ericsson KA. Deliberate practice and acquisition of expert performance: a general overview. Acad Emerg Med. 2008;15(11):988-994. https://doi.org/10.1111/j.1553-2712.2008.00227.x
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