Factors impeding the supply of over-the-counter medications according to evidence-based practice: A mixed-methods study

Abstract

Objective Despite the positive attitudes pharmacists have toward evidence-based practices (EBPs), its application in community pharmacies in Saudi Arabia is lacking. Therefore, this study aimed to explore and assess EBPs by community pharmacists in Saudi Arabia when they dispense over-the-counter (OTC) medications for three minor ailments: diarrhea, cough, and the common cold. Research design and methods We used a mixed-methods approach consisting of two study parts. The first was a quantitative investigation that used mystery shoppers. Four researchers, posing as mystery shoppers, visited 214 randomly selected pharmacies in the Riyadh region of Saudi Arabia. They used 14 questions from a standardized checklist to examine EBPs by community pharmacists. The qualitative part of the study entailed three focus-group discussions with 13 pharmacists from different community practice settings and explored factors that affected the application of EBPs when supplying OTC medications from the pharmacists’ point of view. Results The analysis indicated that 40% of pharmacists dispensed OTC medications according to EBPs. Logistic regression analysis showed that one question, "Describe your symptoms", predicted the correct supply of OTC medications (p = 0.021). The qualitative section of the study identified nine factors that affected EBP. Some of these factors facilitated EBP, such as established patient-pharmacist relationships, some acted as barriers such as conflicts between available evidence, while other factors could either facilitate or hinder EBPs, such as the health literacy of the patient. Conclusion Given that dispensing OTC medication is a core function of pharmacists, this study uncovered low adherence to EBPs by community pharmacists in Saudi Arabia when dispensing OTC medication for three minor ailments: diarrhea, cough, and the common cold. Furthermore, this study identified a number of explanatory factors for this low adherence. Targeting these factors could help change the behavior of pharmacists and decrease undesirable outcomes.

Critical appraisal of simulated patient methodology to assess the practice of community pharmacist in the Middle East and North Africa region: A systematic review

“…A broad variety of terms were used in the studies to the individuals used to perform the simulated visits. The individuals were described as SP 37 (82.2%), 19 , 20 , 22 - 28 , 30 - 36 , 38 , 41 - 45 , 47 - 52 , 54 - 56 , 58 - 63 simulated client 10 (22.2%), 18 , 21 , 24 , 27 , 29 , 35 , 39 , 40 , 47 , 57 and mystery shopper 10 (22.2%), 23 , 26 , 29 , 32 , 40 - 42 , 54 , 55 , 59 mystery patient 3 (6.7%), 21 , 26 , 32 pseudo patient 4 (8.9%), 21 , 23 , 24 , 55 pseudo customer 3 (6.7%), 23 , 24 , 42 investigator 2 (4.4%), 18 , 47 covert patient 1 (2.2%), 21 pseudo patron 1(2.2%), 23 standardized client 1(2.2%), 21 standardized patient 1 (2.2%), 55 shopper patient 1(2.2%), 23 simulated customer 1 (2.2%), 39 simulated shopper 1 (2.2%), 21 secret shopper 1 (2.2%), 58 surrogate shopper 1 (2.2%), 21 surrogate client 1 (2.2%). 21 In addition, many articles provided brief background or defined what was meant by SP or the equivalent term 17 (37.8%).…”

“…A broad variety of terms were used in the studies to the individuals used to perform the simulated visits. The individuals were described as SP 37 (82.2%), 19,20,[22][23][24][25][26][27][28][30][31][32][33][34][35][36]38,[41][42][43][44][45][47][48][49][50][51][52][54][55][56][58][59][60][61][62][63] simulated client 10 (22.2%), 18,21,24,27,29,35,39,40,47,5 7 and mystery shopper 10 (22.2%), 23,26,29,32,[40][41][42]54,55,59 mystery patient 3 (6.7%), 21,26,…”

Over-the-Counter Medication Use among Parents in Saudi Arabia

“…Furthermore, more than 40% of parents relied on information received from community pharmacists about the appropriate dosage of the OTC medication. However, low adherence to evidence-based practices by community pharmacists in Saudi Arabia when dispensing OTC medication has been reported, as only 40% of pharmacists dispensed OTC medications according to the recommended guidelines [31,32]. Those results highlight the importance of monitoring community pharmacists and encouraging them to keep updated while taking the initiative to actively guide patients and provide information about the proper use of OTC medications and their possible negative outcomes when dispensing medications [33].…”

An online cross-sectional survey investigating community pharmacists’ information needs for evidence-based self-medication counselling

“…Very little attention has been paid to community pharmacists' information needs for evidence-based self-medication counselling. Up to now, research has tended to focus more on investigating barriers, educational interventions and the status quo of counselling-practice [9,12,13,19,20,41]. This study was therefore set out with the aim of gaining an insight into their information needs to help facilitate EbPharm into practice.…”

“…Previously published studies have shown, however, that external evidence in particular is only sparsely integrated into everyday counselling [9][10][11][12][13][14][15][16][17][18]. Barriers such as a lack of time, and missing information resources were identi ed as the main reason causing the evidence-to-practice-gap [19][20][21][22][23].…”