Do community pharmacists in Qatar manage acute respiratory conditions rationally? A simulated client study

Abstract

Objectives This study evaluated Qatar's community pharmacists’ therapeutic recommendations, medication labelling, dispensing and counselling practices in response to common cold and allergic rhinitis symptoms. Methods A simulated client method was used to assess the practice behaviour of community pharmacists. Twenty‐five pharmacies in Qatar were randomly selected and further randomised into two groups: common cold (n = 15) and allergic rhinitis (n = 10). The pharmacies were visited or called according to the study group twice by two independent simulated clients; each simulated client visited or called the 25 pharmacies once. Therapeutic recommendations, labelling, dispensing and counselling practices from the studied pharmacies were compared to Joint FIP/WHO (International Pharmaceutical Federation/World Health Organization) standard guidelines. Data analyses were performed using both descriptive and inferential statistics (α = 0.05). Key findings Cough syrups (37%), analgesics (31%) and antihistamines (19%) were the most frequently dispensed medicines in the common cold scenario. Pharmacists were less likely to dispense cough syrups (12%) and analgesics (12%), but were more likely to dispense antihistamines (35%) in the allergic rhinitis scenario. Antibiotics were found in three encounters for each scenario. Many community pharmacists did not adhere to medicine labelling standard. No significant differences were found regarding labelling practices and important questions to be asked (P > 0.05), except questions related to fever and cough symptoms (P < 0.05). The median cost for treating allergic rhinitis was higher, but this did not reach statistical significance (QAR 60 versus QAR 51 (equivalent to USD 16.44 versus USD 13.97), P = 0.586). Furthermore, no significant differences were found between pharmacists’ gender (P = 0.642), pharmacy type (P = 0.487) and duration of encounter (P = 0.266). Conclusions Community pharmacists in Qatar appeared to exhibit practices that are below the established standards in response to common cold and allergic rhinitis symptoms.

Evaluation of Community Pharmacists’ Professional Practice and Management of Patient's Respiratory Conditions

“…[ 21 22 ] The results of this study highlight the overall poor skills of pharmacists in asking questions for differential diagnosis between the two conditions. The results are similar to those of a study conducted by Mohamed Ibrahim et al [ 13 ] in which community pharmacists were unable to make a differential diagnosis between the common cold and allergic rhinitis. In addition, neither the type of pharmacies approached (independent vs. chain) nor the gender of pharmacists included in the study affected the results of either scenario.…”

“…The protocol for differential diagnosis and the data collection form were extracted from the Joint FIP/WHO Guidelines on Pharmacy Practice. [ 20 ] The tool was pilot tested and validated by Mohamed Ibrahim et al [ 13 ] The two simulated patients (i.e., two pharmacy students in their 5 th year of pharmacy, of the same age and gender) were trained for the common cold and allergic rhinitis scenarios using practice demonstrations and role-playing to learn standardized answers. A panel of three experts (two pharmacy faculty members and one practice clinical pharmacist) provided input during the 1.5 h training session; the simulated patients learned about the two scenarios, as well as how to respond to a pharmacist's questions during the process of enacting a particular scenario.…”

“…The form that the simulated patients needed to complete after each visit was adopted from a previous study in Qatar. [ 13 ] During the pharmacy visit, simulated patients gathered information such as pharmacist background, suggested alternatives for treating the conditions, advice regarding the use of antibiotics, and medication labeling practices. The simulated patients also observed whether the pharmacist prescribed antibiotics voluntarily or upon request by the simulated patient.…”

“…[ 12 ] Furthermore, both allergic rhinitis and the common cold are associated with an enormous economic burden as assessed by lost productivity and expenditures for treatment if not treated appropriately. [ 4 6 13 14 ]…”

Do north-eastern German pharmacies recommend a necessary medical consultation for acute diarrhoea? Magnitude and determinants using a simulated patient approach

“…Although studies available from Germany regarding the quality of advice provided in CPs reveal significant deficits, analogous to the international literature [9][10][11][12] , indications other than acute diarrhoea in adults have been investigated in scientific 13,14 and non-scientific studies [15][16][17][18][19] . Because of this lack of studies specifically for acute diarrhoea, the quality of advice provided for acute diarrhoea in adults was analysed for Germany for the first time in 2014 and also identified clear deficiencies 20 .…”