Non-prescription medicines: a process for standards development and testing in community pharmacy
- 186 Downloads
The objective of the study was to develop and test standards of practice for handling non-prescription medicines.
In consultation with pharmacy registering authorities, key professional and consumer groups and selected community pharmacists, standards of practice were developed in the areas of Resource Management; Professional Practice; Pharmacy Design and Environment; and Rights and Needs of Customers. These standards defined and described minimum professional activities required in the provision of non-prescription medicines at a consistent and measurable level of practice. Seven standards were described and further defined by 20 criteria, including practice indicators. The Standards were tested in 40 community pharmacies in two States and after further adaptation, endorsed by all Australian pharmacy registering authorities and major Australian pharmacy and consumer organisations. The consultation process effectively engaged practicing pharmacists in developing standards to enable community pharmacists meet their legislative and professional responsibilities.
Main outcome measures
Community pharmacies were audited against a set of standards of practice for handling non-prescription medicines developed in this project. Pharmacies were audited on the Standards at baseline, mid-intervention and post-intervention. Behavior of community pharmacists and their staff in relation to these standards was measured by conducting pseudo-patron visits to participating pharmacies.
The testing process demonstrated a significant improvement in the quality of service delivered by staff in community pharmacies in the management of requests involving non-prescription medicines. The use of pseudo-patron visits, as a training tool with immediate feedback, was an acceptable and effective method of achieving changes in practice. Feedback from staff in the pharmacies regarding the pseudo-patron visits was very positive.
Results demonstrated the methodology employed was effective in increasing overall compliance with the Standards from a rate of 47.4% to 70.0% (P < 0.01). This project led to a recommendation for the development and execution of a national implementation strategy.
KeywordsAustralia Community pharmacist Non-prescription OTC Standards of practice Training
Funding for this project was obtained from the Australian Government Department of Health and Ageing through the 3rd Community Pharmacy Agreement Research and Development Program.
Conflicts of Interest Professor Benrimoj and Dr de Almeida Neto have been involved with professional pharmacy organisations in Australia, which may have an interest in the development of standards of practice for the provision of non-prescription medicines.
- 1.Lam P, Krass I. Prescription-related counselling - What information do you offer? Aust Pharm 1995;14:342–7.Google Scholar
- 2.Mott K, Eldridge F, Gilbert A, March G, Lawson T, Vitry A, et al. Consumer needs and expectations of community pharmacy. 2005. Report prepared for the Pharmacy Guild of Australia by the Quality Use of Medicines and Pharmacy Research Centre. Date accessed 27/06/06 http://beta.guild.org.au/research/project_display.asp?id = 284 Google Scholar
- 3.March G, Gilbert A, Roughead E, Quintrell N. Developing and evaluating a model for pharmaceutical care in Australian community pharmacies. Int J Pharm Pract 1999;7:220–9.Google Scholar
- 4.Anon. Can you rely on your pharmacist? Consumer (magazine of the New Zealand Consumers’ Institute) 1996;(346):6–9.Google Scholar
- 5.de Almeida Neto AC, Benrimoj SI, Kavanagh DJ, Boakes RA. Novel educational training program for community pharmacists. Am J Pharm Educ 2000;64:302–7.Google Scholar
- 6.de Almeida Neto AC, Benrimoj SI, Kavanagh DJ, Boakes RA. A pharmacy-based protocol and training program for non-prescription analgesics. J Soc Adm Pharm 2000;17:183–92.Google Scholar
- 8.Poston J, Kennedy R, Waruszynski B. Initial results from the Community Pharmacist Intervention Study. Can Pharm J 1995;127:18–25.Google Scholar
- 9.Stewart K, Garde T, Benrimoj SI. Over the counter medication sales in community pharmacy - A. Direct product requests and symptom presentation. Aust J Pharm 1985;66:979–82.Google Scholar
- 11.Bandura A. Social foundations of thought and action. Englewood Cliffs, NJ: Prentice Hall; 1986. ISBN 013815614X.Google Scholar
- 12.Prochaska JO, Di Clemente CC. Towards a comprehensive model of change. In: Miller WR, Heather N, (editors). Treating addictive behaviours. Plenum, New York, NY: Plenum Press; 1986. ISBN 0306422484.Google Scholar
- 13.Winett RA, King AC, Altman DG. Health psychology and public health: an integrative approach. New York, NY: Pergamon; 1989. ISBN 008033640X.Google Scholar
- 14.Oxman A, Thomson M, Davis D, Haynes R. No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. Can Med Assoc J 1995;153:1423–31.Google Scholar
- 15.Thomson MA, Oxman AD, Davis DA, Haynes RB, Freemantle N, Harvey EL. Audit and feedback to improve health professional practice and health care outcomes. In: Cochrane Collaboration (editor). Cochrane Library. Issue 3. Oxford, UK: Update Software; 1998.Google Scholar
- 16.Krska J, Kennedy E. An audit of responding to symptoms in community pharmacy. Int J Pharm Prac 1996;4:129–35.Google Scholar
- 17.Skeff K, Berman J, Stratos G. A review of clinical teaching improvement methods and a theoretical framework for their evaluation. In: Edwards J, Marier R, (editors). Clinical teaching for medical residents. New York, NY: Springer; 1988. ISBN 0826156002.Google Scholar
- 18.de Almeida Neto AC. Changing pharmacy practice: the Australian experience. Pharm J 2003;270:235–6.Google Scholar
- 19.The Canadian National Association of Pharmacy Regulatory Authorities. National Standards of Practice for Schedule II and Schedule III Drugs, 1995.Google Scholar
- 20.The New Zealand Ministry for Health. Draft statement of expectations of the pharmacist in the sale of OTC medicines, 1995.Google Scholar
- 21.The Pharmaceutical Society of Australia. Statement on the delivery of pharmacy (S2) and pharmacist only (S3) medicines within community pharmacies, 1997.Google Scholar
- 22.The Royal Australian College of General Practitioners. Entry standards for general practices, 1996.Google Scholar
- 23.Pharmacy Guild of Australia. Quality care standards for Australian pharmacies. Deakin ACT, 1998.Google Scholar
- 24.Linstone H, Turoff M. The Delphi method: techniques and applications. In: Linstone HA, Turoff M, editors. New Jersy’s Science and Tecnology University, 2002.Google Scholar
- 25.Herson M, Barlow D. Single-case experimental designs: strategies for studying behaviour change. New York, NY: Pergammon Press; 1976. ISBN 0080195113.Google Scholar
- 26.Benrimoj SI, Emmerton L, Taylor R, Williams K, Gilbert A, Quintrell N, et al. A cost-benefit analysis of pharmacist only (S3) and pharmacy medicines (S2) and risk-based evaluation of the Standards. June 2005. Report prepared for the Pharmacy Guild of Australia by the University of Sydney. Date accessed 18/10/06 http://beta.guild.org.au/research/project_display.asp?id = 246Google Scholar