Patient medication counselling in community pharmacy: evaluation of the quality and content

Abstract

Background Patient medication counselling (PMC) is a pharmaceutical care service targeted at optimizing patient drug use, safety and improving treatment outcomes. This study assessed the content and quality of PMC from the community pharmacists’ (CPs) and pharmacy customers’ (PCs) perspectives. Methods A cross-sectional questionnaire-guided survey was conducted in Ibadan, Nigeria, among 125 CPs and 612 PCs. The 35-counselling items validated United States Pharmacopeia Medication Counselling Behaviour Guideline scale with 10-point graded responses (1 = poor to 10 = excellent) was used. Self-reported medication counselling information content provided by CPs and received by PCs was assessed and expressed in median and interquartile ranges. The quality of PMC was evaluated and graded as poor (1–29.9%), unsatisfactory (30–59.9%), satisfactory (60–79.9%) and excellent (80–100%). Associations between demographic variables and overall quality of counselling were determined with Mann–Whitney U and Kruskal–Wallis tests at p < 0.05. Results The response rate was 92.5% and 97.6% for PCs and CPs, respectively. The PCs’ opinions on the individual content of the PMC provided by the CPs were significantly different from the pharmacists’ self-report (p < 0.05). Some of the PMC content included how to take the medicine PC = 6.00 (2.00) vs CP = 8.00 (2.00), information on possible side effects PC = 6.00 (2.00) vs CP = 8.00 (2.00), taking history of allergies and other medications PC = 6.00 (6.00) vs CP = 7.00 (1.00), and how to incorporate drug regimen into daily routine PC = 5.00 (6.00) vs CP = 8.00 (3.00). The quality of PMC purportedly provided by CPs and received by the PCs was satisfactory (75%) and unsatisfactory (55%), respectively. The quality of communication counselling offered by CPs trained in Nigeria (Mean rank = 62.49) was higher than those trained outside Nigeria (Mean rank = 26.40), U = 228.00, p = 0.024. The PC’s age, marital status, and highest educational qualification were significantly associated with their opinion on the quality of counselling received. Conclusions Both the community pharmacists and pharmacy customers reported the provision of patient medication counselling on side effects, drug usage, medication history and allergies among others. However, the quality of counselling provided by the pharmacists was satisfactory, but the quality of counselling received by the pharmacy customers was unsatisfactory. Pharmacists may need to engage pharmacy customers more during medication counselling.

An initial reliability analysis of a patient counseling rubric to objectively measure student pharmacist performance

“…The rubric was developed based on a literature review of best practices for pharmacist-led patient medication counseling in a community pharmacy setting [ [14] , [15] , [16] , [17] ]. After identifying relevant literature, common themes were compared to the federal and state legal requirements for patient counseling [ [7] , [8] , [9] ]. Eighteen items consistent with legal requirements and consistently recognized as best practices were included as rubric items ( Table 1 ).…”

“…Although patient counseling is critical to patient treatment, it must be more valued and practiced in pharmacy education [ 6 , 7 ]. In 1990, the Omnibus Budget Reconciliation Act of 1990 (OBRA’ 90) was signed into law to ensure patient counseling for Medicaid beneficiaries by pharmacists [ 8 ].…”

“…In 1990, the Omnibus Budget Reconciliation Act of 1990 (OBRA’ 90) was signed into law to ensure patient counseling for Medicaid beneficiaries by pharmacists [ 8 ]. OBRA’ 90 aimed to improve patients' understanding of the medication their doctors prescribe [ 7 , 8 ]. Many states, including Texas, adopted similar administrative codes directing pharmacists to perform mandatory patient counseling or, at a minimum, offer counseling to all patients [ 9 ].…”

“…It is also estimated that given the small percentage of medical information patients can retain, nearly half is misremembered [ 12 , 13 ]. Due to the high prevalence of medication-related problems and low accuracy of patient recall, it is clear that a more effective communication model is needed for student pharmacists [ [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] ].…”

Pharmacists’ Medication Counseling Practices and Knowledge and Satisfaction of Patients With an Outpatient Hospital Pharmacy Service

“…Patient medication counseling: a process of giving adequate information in the form of verbal instructions to ensure that the patient has an unequivocal understanding of the instructions for use and any distinguishing characteristics or requirements of the medicine. 16 The information may be provided orally or in written form to clients or their carer with instructions on use, advice on side effects, precautions, storage, diet, and lifestyle modifications. Pharmacy professionals: in the Ethiopian context, pharmacy professionals are personnel who might be either pharmacists (bachelor degree holders) or druggists (diploma level).…”