Covert and Overt Observations in Pharmacy Practice

Costa, Filipa Alves da

doi:10.1007/978-981-15-2993-1_5

Cited by 10 publications

(8 citation statements)

References 61 publications

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“…The cross-sectional study was based on the internationally widely used [ 46 , 47 ] simulated patient methodology (SPM) as a form of covert participatory observation [ 48 ]. Here, a person, who in an ideal case, is indistinguishable from a real customer, visits a CP to simulate a real-life counseling situation based on a previously defined scenario.…”

Section: Methodsmentioning

confidence: 99%

The Quality of Counseling for Headache OTC Medications in German Community Pharmacies Using a Simulated Patient Approach: Are There Differences between Self-Purchase and Purchase for a Third Party?

Langer

Kunow

2022

The Scientific World Journal

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Background. In Germany—as worldwide—headache is one of the most frequent causes of self-medication. The dispensing of over-the-counter (OTC) medications may only be carried out by community pharmacies (CPs). In doing so, CPs have to ensure “adequate” counseling, for both self-purchase and purchase for a third party, which also occurs in everyday pharmacy practice. The aim of this study was to evaluate the quality of counseling for headache OTC medications in German CPs and, as the first study worldwide, to analyze whether and to what extent there are differences in counseling between self-purchase and purchase for a third party. Methods. A cross-sectional study was carried out using the covert simulated patient methodology (SPM) in all 42 CPs in the German big city Potsdam. With the help of 8 trained simulated patients (SPs), each CP was visited four times by a different SP. The SPs simulated in each CP two scenarios two times with the demand for an OTC medication against headache, which differed only in whether the demand was for themselves or for their boyfriend/girlfriend. Results. All 168 planned pharmacy visits (84 visits per scenario) were successfully carried out. Overall, the median counseling score was 3.0 out of 9 points (interquartile range [IQR 2.0]). There were no significant differences between the two scenarios (Wilcoxon signed-rank test; p = 0.495 , r = 0.053). In a multivariate binary logistic regression analysis, the counseling level and the different scenarios were not significantly associated (adjusted odds ratio [AOR] = 1.635, 95% CI = 0.673–3.972, p = 0.278 ). Conclusions. Due to the partly considerable deficits in counseling of German CPs, policy-makers and the regional chambers of pharmacists are called upon to take appropriate measures to improve the quality of counseling. It is positive that no differences in counseling between self-purchase and purchase for a third party were found, but further verifying studies with a modified methodology are recommended.

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Section: Methodsmentioning

confidence: 99%

The Quality of Counseling for Headache OTC Medications in German Community Pharmacies Using a Simulated Patient Approach: Are There Differences between Self-Purchase and Purchase for a Third Party?

Langer

Kunow

2022

The Scientific World Journal

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“…The quality of the counselling provided in the pharmacies visited is determined using the SPM, which has often been applied in international studies in the community pharmacy (CP) setting [ 33 , 53 , 54 ]. The SPM is a covert participatory observation [ 55 ] by a person, who in an ideal case cannot be differentiated from a real customer (simulated patient, SP), who visits a CP to simulate a real-life counselling situation based on a previously defined scenario. The data are then collected according to previously defined criteria using an assessment form and the CP is provided with performance feedback, if applicable [ 33 ].…”

Section: Methodsmentioning

confidence: 99%

The Quality of Counselling for Oral Emergency Contraceptive Pills—A Simulated Patient Study in German Community Pharmacies

Langer

Grimm

Lungfiel

et al. 2020

IJERPH

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Background: In Germany, there are two different active substances, levonorgestrel (LNG) and ulipristal acetate (UPA), available as emergency contraception (the “morning after pill”) with UPA still effective even 72 to 120 h after unprotected sexual intercourse, unlike LNG. Emergency contraceptive pills have been available without a medical prescription since March 2015 but are still only dispensed by community pharmacies. The aim of this study was to determine the counselling and dispensing behaviour of pharmacy staff and the factors that may influence this behaviour in a scenario that intends that only the emergency contraceptive pill containing the active substance UPA is dispensed (appropriate outcome). Methods: A cross-sectional study was carried out in the form of a covert simulated patient study in a random sample of community pharmacies stratified by location in the German state of Mecklenburg-Vorpommern and reported in accordance with the STROBE statement. Each pharmacy was visited once at random by one of four trained test buyers. They simulated a product-based request for an emergency contraceptive pill, stating contraceptive failure 3.5 days prior as the reason. The test scenario and the evaluation forms are based on the recommended actions, including the checklist from the Federal Chamber of Pharmacies. Results: All 199 planned pharmacy visits were carried out. The appropriate outcome (dispensing of UPA) was achieved in 78.9% of the test purchases (157/199). A significant correlation was identified between the use of the counselling room and the use of a checklist (p < 0.001). The use of a checklist led to a significantly higher questioning score (p < 0.001). In a multivariate binary logistic regression analysis, a higher questioning score (adjusted odds ratio [AOR] = 1.41; 95% CI = 1.22–1.63; p < 0.001) and a time between 12:01 and 4:00 p.m. (AOR = 2.54; 95% CI = 1.13–5.73; p = 0.024) compared to 8:00 to 12:00 a.m. were significantly associated with achieving the appropriate outcome. Conclusions: In a little over one-fifth of all test purchases, the required dispensing of UPA did not occur. The use of a counselling room and a checklist, the use of a checklist and the questioning score as well as the questioning score and achieving the appropriate outcome are all significantly correlated. A target regulation for the use of a counselling room, an explicit guideline recommendation about the use of a checklist, an obligation for keeping UPA in stock and appropriate mandatory continuing education programmes should be considered.

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“…Against the background of a nationwide study, calls are to be preferred to visits-which have already been used in German CPs [15,60,63,64], but only in relation to one city or one federal state-as the implementation of calls without the requirement of a physical presence in the CP is less costly and thus more feasible. Following the international literature [59,[65][66][67], the SPM in the form of covert mystery calls is a covert participant observation by a person (mystery caller (MC)), -who contacts a CP, -with the help of a call, -to simulate a lifelike conversation situation based on a predefined scenario.…”

Section: Methodsmentioning

confidence: 99%

Pharmacy Practice and Administration

2022

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Covert and Overt Observations in Pharmacy Practice

Cited by 10 publications

References 61 publications

The Quality of Counseling for Headache OTC Medications in German Community Pharmacies Using a Simulated Patient Approach: Are There Differences between Self-Purchase and Purchase for a Third Party?

The Quality of Counseling for Headache OTC Medications in German Community Pharmacies Using a Simulated Patient Approach: Are There Differences between Self-Purchase and Purchase for a Third Party?

The Quality of Counselling for Oral Emergency Contraceptive Pills—A Simulated Patient Study in German Community Pharmacies

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