Abstract
Background For a safe drug therapy, outpatients have to self-administer their medications correctly. However, these procedures are known as error-prone. In community pharmacies, the pharmaceutical staff has to recognize patients’ counseling needs and to use adequate strategies to prevent possible handling errors. Objective Assessing the experiences and opinions of pharmaceutical staff on counseling patients on practical drug handling. Setting Community pharmacies in a German city and surrounding area. Method Descriptively evaluating a self-administered questionnaire to be completed by members of the pharmaceutical staff involved in patient counseling. Main outcome measures Estimated counseling needs of patients, current counseling strategies and limitations of counseling. Results 520 staff members of 119 pharmacies (59.8%, 199 invited) participated. The majority prioritized counseling on dosage over counseling on practical drug handling. Participants saw a particular need when medication was dispensed for the first time compared to repeated use (all medication types, each p < 0.001). The need and counseling strategy depended on the dosage form with a special focus on practical demonstration in bronchopulmonary (83.9%) and oral liquid formulations (54.3%). As one main limitation, they cited the refusal of patients to accept information on drug handling (34.4%). Conclusion Participants considered drug handling an important counseling topic. However, reduced awareness for handling errors made at repeated use and at administration of certain dosage forms may affect the safety and success of medication therapy. Additionally, patients’ resistance to information may limit the intent on counseling. Still, it is important to verify patients’ abilities to handle their medication as intended.
Similar content being viewed by others
References
Yin HS, Mendelsohn AL, Wolf MS, Parker RM, Fierman A, van Schaik L, et al. Parents’ medication administration errors. Role of dosing instruments and health literacy. Arch Pediatr Adolesc Med. 2010;164:181–6.
Quinzler R, Gasse C, Schneider A, Kaufmann-Kolle P, Szecsenyi J, Haefeli WE. The frequency of inappropriate tablet splitting in primary care. Eur J Clin Pharmacol. 2006;62:1065–73.
Schiele JT, Quinzler R, Klimm H-D, Pruszydlo MG, Haefeli WE. Difficulties swallowing solid oral dosage forms in a general practice population: prevalence, causes, and relationship to dosage forms. Eur J Clin Pharmacol. 2013;69:937–48.
Cornish P. “Avoid the crush”: hazards of medication administration in patients with dysphagia or a feeding tube. CMAJ. 2005;172:871–2.
Kaune A, Schumacher PM, Hoppe SC, Syrbe S, Bernhard MK, Frontini R, et al. Administration of anticonvulsive rescue medication in children—discrepancies between parents’ self-reports and limited practical performance. Eur J Pediatr. 2016;175:1139–46.
Molimard M, Raherison C, Lignot S, Depont F, Aboulefath A, Moore N. Assessment of handling of inhaler devices in real life: an observational study in 3811 patients in primary care. J Aerosol Med. 2003;16:249–54.
Hatley RHM, Parker J, Pritchard JN, von Hollen D. Variability in delivered dose from pressurized metered-dose inhaler formulations due to a delay between shake and fire. J Aerosol Med Pulm Drug Deliv. 2017;30:71–9.
Melani AS, Bonavia M, Cilenti V, Cinti C, Lodi M, Martucci P, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105:930–8.
Puspitasari HP, Aslani P, Krass I. A review of counseling practices on prescription medicines in community pharmacies. Res Soc Adm Pharm. 2009;5:197–210.
Buring SM, Kirby J, Conrad WF. A structured approach for teaching students to counsel self-care patients. Am J Pharm Educ. 2007;71:1–7.
ABDA. Leitlinie der Bundesapothekerkammer zur Qualitätssicherung, Information und Beratung des Patienten bei der Abgabe von Arzneimitteln – Erst- und Wiederholungsverordnung. 2016. https://www.abda.de/fileadmin/assets/Praktische_Hilfen/Leitlinien/Rezeptbelieferung/LL_Info_Beratung_Rezept.pdf. Accessed 7 Jul 2018.
ABDA. Leitlinie der Bundesapothekerkammer zur Qualitätssicherung, Information und Beratung des Patienten bei der Abgabe von Arzneimitteln – Selbstmedikation. 2016. https://www.abda.de/fileadmin/assets/Praktische_Hilfen/Leitlinien/Selbstmedikation/LL_Info_Beratung_SM.pdf. Accessed 7 Jul 2018.
ASHP. Guidelines on pharmacist-conducted patient education and counseling. Am J Health-Syst Pharm. 1997;54:431–4.
Pharmaceutical Society of Australia. Professional practice standards V5. 2017. https://www.psa.org.au/wp-content/uploads/2018/08/Professional-Practice-Standards-v5.pdf. Accessed 25 Nov 2018.
Pharmaceutical Services Negotiating Committee UK. Medicines use review—suggested questions. 2012. http://archive.psnc.org.uk/data/files/PharmacyContract/Contract_changes_2011/Medicines_Use_Review_Exemplar_Interview_Schedule_Jan_2012.pdf. Accessed 7 Jul 2018.
ABDA. German pharmacies: figures, data, facts 2017. 2017. https://www.abda.de/fileadmin/assets/ZDF/ZDF_2017/ABDA_ZDF_2017_Brosch_english.pdf. Accessed 17 Oct 2018.
Mayer HO. Interview und schriftliche Befragung. Grundlagen und Methoden empirischer Sozialforschung. 6th ed. München: Oldenbourg; 2013.
Bertsche T, Bertsche A, Krieg E-M, Kunz N, Bergmann K, Hanke G, et al. Prospective pilot intervention study to prevent medication errors in drugs administered to children by mouth or gastric tube: a programme for nurses, physicians and parents. Qual Saf Health Care. 2010;19:e26.
Niemann D, Bertsche A, Meyrath D, Oelsner S, Ewen AL, Pickardt B, et al. Drug handling in a paediatric intensive care unit—can errors be prevented by a three-step intervention? Klin Padiatr. 2014;226:62–7.
Niemann D, Bertsche A, Meyrath D, Koepf ED, Traiser C, Seebald K, et al. A prospective three-step intervention study to prevent medication errors in drug handling in paediatric care. J Clin Nurs. 2015;24:101–14.
Neininger MP, Kaune A, Bertsche A, Rink J, Musiol J, Frontini R, et al. How to improve prescription of inhaled salbutamol by providing standardised feedback on administration: a controlled intervention pilot study with follow-up. BMC Health Serv Res. 2015;15:40.
Bousquet J, Mantzouranis E, Cruz AA, Ait-Khaled N, Baena-Cagnani CE, Bleecker ER, et al. Uniform definition of asthma severity, control, and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol. 2010;126:926–38.
The Inhaler Error Steering Committee, Price D, Bosnic-Anticevich S, Briggs A, Chrystyn H, Rand C, et al. Inhaler competence in asthma: Common errors, barriers to use and recommended solutions. Respir Med. 2013;107:37–46.
Yin HS, Parker RM, Sanders LM, Dreyer BP, Mendelsohn AL, Bailey S, et al. Liquid medication errors and dosing tools: a randomized controlled experiment. Pediatrics. 2016;138:e20160357.
Bundesinstitut für Arzneimittel und Medizinprodukte. Rote Hand Brief: Levetiracetam-haltige Darreichungsformen der 100 mg/ml Lösung zum Einnehmen: Sicherheitshinweise zum Risiko einer Überdosierung durch Medikationsfehler. 2016. https://www.bfarm.de/SharedDocs/Risikoinformationen/Pharmakovigilanz/DE/RHB/2016/rhb-levetiracetam.pdf. Assessed 14 Jun 2018.
European Medicines Agency. EMA recommends measures to ensure safe use of Keppra oral solution. 2016. https://www.ema.europa.eu/en/news/ema-recommends-measures-ensure-safe-use-keppra-oral-solution. Accessed 25 Nov 2018.
Karagama YG, Rashid M, Lancaster JL, Karkanevatos A, Williams RS. Intranasal delivery of drugs to eustachian tube orifice. J Laryngol Otol. 2011;125:934–9.
Karagama YG, Lancaster JL, Karkanevatos A, O’Sullivan G. Delivery of nasal drops to the middle meatus: which is the best head position? Rhinology. 2001;39:226–9 (abstract).
McCroskey JC, McCroskey LL. Self-report as an approach to measuring communication competence. Commun Res Rep. 1988;5:108–13.
Williams NT. Medication administration through enteral feeding tubes. Am J Health Syst Pharm. 2008;65:2347–57.
Acknowledgements
We thank Anne Diessler, pharmacy student, for the support in the development and pretest of the self-administered questionnaire as well as for the support in development of the recruiting strategy. Also, we thank André Drechsler, Grit Lux and Barbara Kubainska, pharmacy students, for their support in the recruitment, distribution and recollection process of the questionnaire and the data entry. We thank all participating members of pharmaceutical staff.
Funding
The project received third party funding by the Lesmüller Stiftung, Munich, Germany, and the Förderinitiative Pharmazeutische Betreuung, Berlin, Germany.
Conflicts of interest
The authors declare that they have no conflicts of interests.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Schumacher, P.M., Neininger, M.P., Kaune, A. et al. Counseling patients on correct drug handling in German community pharmacies: experiences and opinions of pharmaceutical staff. Int J Clin Pharm 41, 151–158 (2019). https://doi.org/10.1007/s11096-018-0757-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11096-018-0757-y