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Lecturer in Pharmacy Practice, School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
Lecturer in Pharmacy Practice, Faculty of Pharmacy, University of Sydney, Sydney, Australia
Professor of Pharmacy Practice, University of Sydney
Reprints: Dr. Kelly, School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand, fax 649 367 7192, fiona.kelly{at}auckland.ac.nz
BACKGROUND: Community pharmacy has long been advocated as an appropriate gateway of supply for nonprescription medicines and health-related advice. Consumers sometimes self-treat the symptoms of minor illness, yet there is conflicting evidence over their ability to do so properly. Emerging trends also suggest a variable approach to nonprescription medicine supply by pharmacy staff. Understanding of this is limited and more structured exploration is needed.
OBJECTIVE: To explore variation in pharmacy staff response to requests for nonprescription medicines from different legislative schedules through analysis of data collected using pseudo-patient methods.
METHODS: Consumers posed as pharmacy patrons (ie, pseudo-patients, simulated patients) and requested 1 of 3 specific nonprescription medicines by name. Two of these, ibuprofen and a branded cold and flu medication, could be sold by any pharmacy staff member (these were considered Pharmacy Medicine). The third, a combination analgesic containing paracetamol (acetaminophen), codeine, and doxylamine, required pharmacist involvement in the sale (considered Pharmacist Only Medicine). Pseudo-patient visits measured the service provided in each pharmacy by observing whether staff performed particular behaviors such as providing advice regarding the drugs.
RESULTS: Staff response was generally superior when pseudo-patients requested the combination analgesic that required pharmacist intervention. Medicine advice was provided verbally to 84.9% of pseudo-patients requesting this analgesic compared with 51.1% of those requesting the cold and flu medication. Similar trends were observed for other behaviors.
CONCLUSIONS: Emerging patterns imply that pharmacy staff response may vary according to the medicine requested. It may be that pharmacists and their staff prioritize drugs or behaviors that they consider critically relevant as part of a risk management approach. This has possible implications for future scheduling policy. Further research using a range of scenarios would more fully explore the breadth of such behavior. This would aid identification of medicines that trigger professional intervention and inform development of targeted training programs.
Key Words: behavior, nonprescription medicine, OTC (over-the-counter) medication, pharmacy, pseudo-patient, self-care, simulated patient, support staff
Published Online, October 20, 2009. www.theannals.com, DOI 10.1345/aph.1L121
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