Self-reported and actual involvement of community pharmacists in patient counseling: a cross-sectional and simulated patient study in Gondar, Ethiopia
Background: Community pharmacists play a crucial role in reducing medication related health problems and improving the patient’s overall wellbeing. Evidence suggests that community pharmacist led counseling services result in a better clinical and self-reported outcome, including a higher level of satisfaction and quality of life.
Objective: This study aims to document self-reported and actual levels of community pharmacists’ involvement in the provision of patient counseling and barriers that limit their involvement in such services.
Methods: Simulated patient visits and a cross-sectional survey of community pharmacists were employed in Gondar town, Ethiopia between March 15 and May 15, 2016 to observe actual counseling practices and to assess their reported counseling practices respectively. Four different scenarios were developed for the simulated patient visit. A well designed questionnaire and an assessment form were used for the survey and simulated patient visit.
Results: In the cross-sectional survey, 84 pharmacists were approached and 78 agreed to participate (92.8 % response rate). Of the respondents, 96.1% agreed/strongly agreed that patient counseling is important and 69.3% strongly agreed that patient counseling should be a professional duty. The most frequent information provided to patients were dosing schedule of drugs, how to take medication, and drug-food interaction. Majority of community pharmacists either strongly agreed (42.1%) or agreed (51.3%) that patients are comfortable towards their counseling practice. A total of 48 simulated visits were conducted and a medicine was dispensed in all visits. In all four scenarios, dosage schedule (100%), how to take medication (97.6%) and drug-food interaction (69.1%) were the most common type of information provided while what to do when dose is missed (100%), contraindication (95.2%) and the importance of compliance or adherence (92.9%) were the most commonly ignored types of information.
Conclusions: The present study emphasizes the existing gap in self-reported and actual counseling practices by community pharmacist in Gondar town, Ethiopia. Hence, the ministry of health, local health policy makers and other stakeholders should collaborate to design interventions to improve community pharmacists’ dispensing and counseling practice.
2. A Call to Action. Preventing U.S. citizens from inappropriate medication use. A white paper on medication safety in the U.S. and the role of community pharmacists Huntingdon Valley, PA: Institute for Safe Medication Practices; 2007
3. Gelayee D.A, Birara M.K. Patient medication counseling: a survey of knowledge, attitude and practice of pharmacy professionals in Gondar, North West Ethiopia. J Sci Res Pharm. 2015;4(2):74-77.
4. Offor I, Enato E. Patients’ Assessment of Pharmacists’ Medication Counseling in a Psychiatric Hospital in Nigeria. Tropical J Pharm Res. 2011;10(4):507-516. doi: 10.4314/tjpr.v10i4.17
5. American Society of Health-System Pharmacists. ASHP guidelines on pharmacist-conducted patient education and counseling. Am J Health Syst Pharm. 1997;54(4):431-434.
6. Puspitasari HP, Aslani P, Krass I. A review of counseling practice on prescription medicines in community pharmacies. Res Social Adm Pharm. 2009;5(3):197-210. doi: 10.1016/j.sapharm.2008.08.006
7. Okumura LM, Rotta I, Correr CJ. Assessment of pharmacist-led patient counseling in randomized controlled trials: a systematic review. Int J Clin Pharm. 2014;36(5):882-891. doi: 10.1007/s11096-014-9982-1
8. Hussain A, Izham M, Ibrahim M. Medication counselling and dispensing practices at community pharmacies: a comparative cross sectional study from Pakistan. Int J Clin Pharm. 2011;33(5):859-867. doi: 10.1007/s11096-011-9554-6
9. Hussain A, Ibrahim MI, Malik M. Assessment of disease management of insomnia at community pharmacies through simulated visits in Pakistan. Pharm Pract (Granada). 2013;11(4):179-184.
10. Coelho RB, Costa FA. Impact of pharmaceutical counseling in minor health problems in rural Portugal. Pharm Pract (Granada). 2014;12(4):451.
11. Health sector development program IV, Ministry of Health, Federal Democratic Republic of Ethiopia, 2010/11-2014/15. http://phe-ethiopia.org/admin/uploads/attachment-721-HSDP%20IV%20Final%20Draft%2011Octoberr%202010.pdf (accessed 17 Nov 2016).
12. Erku DA, Gebresillassie BM, Mekuria AB, Surur AS. Extent of dispensing prescription-only medications without a prescription in community drug retail outlets in Addis Ababa, Ethiopia: a simulated-patient study. Drug Healthc Patient Saf. 2016;8:65-70. doi: 10.2147/DHPS.S106948
13. Dameh M, Norris P, Green J. New Zealand pharmacists’ experiences, practices and views regarding antibiotic use without prescription. J Prim Health Care. 2012;4(2):131-140.
14. Ayalew E, Seid Y, Agalu A. Knowledge, attitude and practice of patient medication counseling among drug dispensers in Mekele town, Northern Ethiopia. Int Res J Pharm Pharmacol. 2014; 4(2):28-34. doi: 10.14303/irjpp.2013.039
15. Gokcekus L, Toklu H.Z, Demirdamar R, Gumusel B. Dispensing practice in the community pharmacies in the Turkish Republic of Northern Cyprus. Int J Clin Pharm. 2012;34(2):312-24. doi: 10.1007/s11096-011-9605-z
16. Alaqeel S, Abanmy N.O. Counseling practices in community pharmacies in Riyadh, Saudi Arabia: a cross-sectional study. BMC Health Serv Res. 2015;15:557. doi: 10.1186/s12913-015-1220-6
17. Nestel D, Bearman M. Simulated Patient Methodology Theory, Evidence and practice. Hoboken, NJ: Wiley; 2015; ISBN: 9781118761007
18. 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. doi: 10.18549/PharmPract.2015.04.597
19. Rodrigues CR, DiPietro NA. Knowledge of folic acid and counseling practices among Ohio community pharmacists. Pharm Pract (Granada). 2012;10(3):168-172.
20. Negru DS, Cristea AN.Petculescu AM. Patient counseling at dispensing OTC medicines in the community pharmacy. Farmacia. 2012;60(1):102-110.
21. Nigussie WD. Patient counselling at dispensing of medicines in health care facility outpatient pharmacies of Bahir Dar city, Northwest Ethiopia. Sci J Public Health.2014;2(2):126-134. doi:10.11648/j.sjph.20140202.22
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