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?

Abstract

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.

Evaluation of knowledge, Attitude and Practice About Self-Medication Regarding OTC Analgesia Among Undergraduate University Students: A Survey-Based Study

“…Most of the male and female students took analgesics for headaches, this may be due to the stress of studying, Similar findings were in study carried out by Bernhard Langer et al, [11] however, the second complaint that led to selfmedication is the period pain (dysmenorrhea) for the female students.…”

Simulated patient methodology as a “gold standard” in community pharmacy practice: Response to criticism

“…One of the reasons for this critique is that in a single contact with a CP, the service process of only one specific pharmacy employee can be observed and evaluated at a given time, whereby only one SP with certain characteristics can participate. Furthermore, the SP can either make a purchase for themselves (self-purchase scenario) or for a third party (purchase for a third-party scenario)[ 12 ]. Finally, the SP's demand may only include a specific product ( e.g., aspirin), condition ( e.g., migraine), or symptom ( e.g., headache) based on a corresponding simulated scenario[ 3 ].…”

Pharmacy Students’ Over-the-counter Recommendations for Primary Dysmenorrhea and Childhood Fever Cases in an Indonesian University

“…Studies related to the provision of antipyretic analgesics for self-medication from community pharmacies have reported that the comprehensiveness of the information gathered, the appropriateness of the recommendations provided, and/or the adequacy of the counseling provided were sub-optimal. [10][11][12][13] In Indonesia, Lestari et al reported that only 9% of the 45 pharmacies in Lamongan district, East Java performed a patient assessment and only less than 10% of pharmacies provided medicine information related to the indication, how to use the medicines, and side effects when handling patients' request for mefenamic acid. 14 A study in Pekanbaru, Riau also showed similar results, in which only 24% of pharmacy staff performed patient assessment when responding to patients with toothache.…”