The competency of Indonesian pharmacy students in handling a self-medication request for a cough: a simulated patient study

Keywords: Cough, Antitussive Agents, Self Medication, Referral and Consultation, Students, Pharmacy, Pharmacists, Patient Simulation, Logistic Models, Multivariate Analysis, Indonesia

Abstract

Background: Cough is a common symptom for which people frequently present to community pharmacies. Previous articles from developing countries have shown that the provision of self-medication consultation for cough in community pharmacies were suboptimal, with knowledge deficiency being a contributing factor. However, little is known regarding the ability of pharmacy students in handling self-medication consultations in developing countries.

Objectives: To measure the competency of Indonesian pharmacy students in providing self-medication consultations for patients with chronic cough and to identify factors associated with the provision of appropriate advice.

Method: This study is a cross-sectional study. A simulated patient method using a product and a symptom-based request of chronic cough was used in students from a pharmacy school in Indonesia. The nature and amount of information gathered and advice provided by pharmacy students were noted and audio-recorded. A logistic regression analysis was performed to identify factors associated with the provision of appropriate advice.

Results: The information gathered by participating students was not comprehensive. The most common types of information gathered were related to the nature and duration of the cough. Information relating to accompanying symptoms, medications, and allergies was gathered in less than 60% of the participating students for both product and symptom based scenarios. The appropriate advice of direct medical referral was provided in 54% and 56% of the 183 participating students for the product and symptom-based request scenarios respectively. Asking about symptom duration and prior medical conditions were positively associated with the provision of appropriate advice in the symptom and product based requests respectively.

Conclusion: Student competency in self-medication consultation for chronic cough needs to be improved. Appropriate information-gathering is a predictor of appropriate advice. Further qualitative research identifying factors affecting students’ competence in providing self-medication consultation is required, so that suitable interventions are developed and implemented.

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References

Chung KF, Pavord ID. Prevalence, pathogenesis, and causes of chronic cough. Lancet. 2008;371(9621):1364-1374. https://doi.org/10.1016/s0140-6736(08)60595-4

Kauffmann F, Varraso R. The epidemiology of cough. Pulm Pharmacol Ther. 2011;24(3):289-294. https://doi.org/10.1016/j.pupt.2010.10.012

Tietze KJ. Cough. In: Krinsky DL, Ferreri SP, Hemstreet B, et al., editors. Handbook of Nonprescription Drugs: An interactive approach to self-care. Washington DC: APhA; 2015.

Irwin RS, French CL, Chang AB, Altman KW; CHEST Expert Cough Panel*. Classification of Cough as a Symptom in Adults and Management Algorithms: CHEST Guideline and Expert Panel Report. Chest. 2018;153(1):196-209. https://doi.org/10.1016/j.chest.2017.10.016

Holzinger F, Beck S, Dini L, Stöter C, Heintze C. The diagnosis and treatment of acute cough in adults. Dtsch Arztebl Int. 2014;111(20):356-363. https://doi.org/10.3238/arztebl.2014.0356

Perotin JM, Launois C, Dewolf M, et al. Managing patients with chronic cough: challenges and solutions. Ther Clin Risk Manag. 2018;14:1041-1051. https://doi.org/10.2147/tcrm.s136036

Limaye D, Limaye V, Krause G, Fortwengel G. A Systematic review of the literature to assess self medication practices. Ann Med Health Sci Res. 2017;7:1-15.

Ambizas EM. Acute cough—does anything help?. US Pharm. 2019;1:8-12.

Rutter P. Role of community pharmacists in patients' self-care and self-medication. Integr Pharm Res Pract. 2015;4:57-65. https://doi.org/10.2147/iprp.s70403

Darmanin Ellul R, Cordina M, Buhagiar A, Fenech A, Mifsud J. Health complaints and use of medicines among adolescents in Malta. Pharm Pract (Granada). 2008;6(3):165-170. https://doi.org/10.4321/s1886-36552008000300008

Brandt N. Self-medication. In:Gellman MD, Turner JR, editors. Encyclopedia of Behavioral Medicine. New York: Springer; 2013.

International Pharmaceutical Federation. Joint statement by The International Pharmaceutical Federation and The World Self-Medication Industry: Responsible self-medication. https://www.fip.org/file/1484 (accessed Feb 1, 2021).

The World Self-Medication Industry. Proceedings of WSMI 6th Asia Pacific Regional Conference. Beijing, 26 – 29 Oct 2004.

Connelly D. The OTC market in Britain in 2015. Pharm J. 2016;296:7887.

Schneider C. Provision of non-prescription medication by community pharmacists in Western Australia. University of Western Australia; 2010.

Blenkinsopp A, Duerden M, Blenkinsopp J. Symptoms in the pharmacy: A guide to the management of common illnesses. Oxford: Wiley-Blackwell; 2018.

Brata C. The provision of self-medication consultations in community pharmacies in an Eastern Indonesian setting. University of Western Australia; 2015.

Brata C, Gudka S, Schneider CR, Everett A, Fisher C, Clifford RM. A review of the information-gathering process for the provision of medicines for self-medication via community pharmacies in developing countries. Res Social Adm Pharm. 2013;9(4):370-383. https://doi.org/10.1016/j.sapharm.2012.08.001

Krinsky DL, Ferreri SP, Hemstreet B, et al, editors. Handbook of nonprescription drugs: an interactive approach to self-care. 18 ed. Washington DC: APhA; 2015.

Brata C, Schneider CR, Marjadi B, Clifford RM. The provision of advice by pharmacy staff in eastern Indonesian community pharmacies. Pharm Pract (Granada). 2019;17(2):1452. https://doi.org/10.18549/pharmpract.2019.2.1452

Schneider CR, Everett AW, Geelhoed E, et al. Provision of primary care to patients with chronic cough in the community pharmacy setting. Ann Pharmacother. 2011;45(3):402-408. https://doi.org/10.1345/aph.1p514

Mináriková D, Fazekaš T, Minárik P, Jurišová E. Assessment of patient counselling on the common cold treatment at Slovak community pharmacies using mystery shopping. Saudi Pharm J. 2019;27(4):574-583. https://doi.org/10.1016/j.jsps.2019.02.005

Brata C, Fisher C, Marjadi B, Schneider CR, Clifford RM. Factors influencing the current practice of self-medication consultations in Eastern Indonesian community pharmacies: a qualitative study. BMC Health Serv Res. 2016;16:179. https://doi.org/10.1186/s12913-016-1425-3

Thang DX. An investigation of non-prescription medicine supply in community pharmacies in Hanoi, Vietnam. University of Nottingham; 2013.

Halila GC, Junior EH, Otuki MF, Correr CJ. The practice of OTC counseling by community pharmacists in Parana, Brazil. Pharm Pract (Granada). 2015;13(4):597. https://doi.org/10.18549/pharmpract.2015.04.597

Hermansyah A, Sainsbury E, Krass I. Multiple policy approaches in improving community pharmacy practice: the case in Indonesia. BMC Health Serv Res. 2018;18(1):449. https://doi.org/10.1186/s12913-018-3258-8

Da Rocha CE, Bispo ML, Alcantara T, et al. What do Brazilian community pharmacists know about self-medication for minor illnesses? A pilot study in the northeast of Brazil. J Appl Pharm Sci. 2014;4(5):12-20. https://doi.org/10.7324/JAPS.2014.40503

Asosiasi Pendidikan Tinggi Farmasi Indonesia. [Academic manuscripts of graduate competency standards and pharmaceutical education curriculum standards]. http://www.aptfi.or.id/dokumen/2016-01-01NAKompetensi&KurAPTFI2013.pdf (accessed Dec 26, 2020).

Fakultas Farmasi Universitas Indonesia. [The UI pharmacist followed UKAI OSCE 2019]. https://farmasi.ui.ac.id/2019/07/apoteker-ui-mengikuti-ukai-osce-2019/ (acessed Mar 3, 2021).

Kristina SA, Gustriawanto N, Rokhman MR, Aditama H, Sari IP. Students’ first experience with objective structured clinical examination in a pharmacy school in Indonesia. J App Pharm Sci. 2018;8(09):102-106. https://doi.org/10.7324/JAPS.2018.8915

Resende KA, Cavaco AM, Luna-Leite MD, et al. Training and standardization of simulated patients for multicentre studies in clinical pharmacy education. Pharm Pract (Granada). 2020;18(4):2038. https://doi.org/10.18549/pharmpract.2020.4.2038

Wigmore BC, Collins JC, Schneider CR, Arias D, Moles RJ. Ability of Pharmacy Students, Pharmacists and Pharmacy Support Staff to Manage Childhood Fever via Simulation. Am J Pharm Educ. 2018;82(10):6445. https://doi.org/10.5688/ajpe6445

Newton GD, Divine H. Patient assessment and consultation. In: Krinsky DL FS, Hemstreet B, Hume AL, et al, editors. Handbook of Non Prescription Drugs. 18 ed. Washington: APhA; 2015.

Packeiser PB, Castro MS. Evaluation of simulated drug dispensing and patient counseling in the course of pharmaceutical improvement: 2009 to 2015. Pharm Pract (Granada). 2020;18(4):1865. https://doi.org/10.18549/pharmpract.2020.4.1865

Harden RM. What is a spiral curriculum?. Med Teach. 1999;21(2):141-143. https://doi.org/10.1080/01421599979752

Setiadi AP, Wibowo Y, Brata C, Halim SV, Wardhani SA, Sunderland B. The role of pharmacists in community education to promote responsible self-medication in Indonesia: an application of the spiral educational model. Int J Clin Pharm. 2020;42(4):1088-1096. https://doi.org/10.1007/s11096-020-01055-8

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

Brata C, Marjadi B, Schneider CR, Murray K, Clifford RM. Information-gathering for self-medication via Eastern Indonesian community pharmacies: a cross-sectional study. BMC Health Serv Res. 2015;15:8. https://doi.org/10.1186/s12913-014-0670-6

Hollnagel E. The ETTO Principle: efficiency-thoroughness trade-off. London: Ashgate; 2009. ISBN 9780754676782.

Puspitasari HP, Faturrohmah A, Hermansyah A. Do Indonesian community pharmacy workers respond to antibiotics requests appropriately?. Trop Med Int Health. 2011;16(7):840-846. https://doi.org/10.1111/j.1365-3156.2011.02782.x

Zawahir S, Lekamwasam S, Aslani P. Antibiotic dispensing practice in community pharmacies: A simulated client study. Res Social Adm Pharm. 2019;15(5):584-590. https://doi.org/10.1016/j.sapharm.2018.07.019

Amin M, Chewing B. Pharmacies without pharmacists: Absenteeism plagues pharmacies in developing countries. Res Soc Adm Pharm. 2017;14:400-401. http://doi.org/10.1016/j.sapharm.2016.10.013

Published
2021-04-28
How to Cite
1.
Brata C, Halim SV, Setiawan E, Presley B, Wibowo YI, Schneider CR. The competency of Indonesian pharmacy students in handling a self-medication request for a cough: a simulated patient study. Pharm Pract (Granada) [Internet]. 2021Apr.28 [cited 2021Jul.26];19(2):2269. Available from: https://pharmacypractice.org/journal/index.php/pp/article/view/2269
Section
Original Research