Utilization of simulated patients to assess diabetes and asthma counseling practices among community pharmacists in Qatar
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Background Patient counseling is one of the most important services a pharmacist can provide to patients. Studies have shown that counseling provided by pharmacists may prevent medication related problems and improve adherence to medication therapy. Objective To explore counseling practices among community pharmacists using simulated patients and to determine if patient, pharmacist, and pharmacy characteristics influence the counseling provided by community pharmacists. Setting Private community pharmacies within Qatar. Method This is a randomized, cross sectional study where simulated patients visited community pharmacies and presented the pharmacist with a new prescription or requested a refill for either a diabetes or asthma medication. Pharmacists completed a questionnaire at the end of the simulated interaction, which was utilized to determine if patient, pharmacist, or pharmacy characteristics had any influence on the counseling provided to patients. A scoring system was devised to assess the pharmacist’s counseling practices. Main outcome measure To evaluate the type of information provided by community pharmacists to the simulated patient regarding diabetes and asthma. Results One hundred and twenty-nine pharmacists were enrolled in the study. Eighty one percent of pharmacists had a score <35%. Medication name (95%), directions (47%), indication (43%), and dose (41%) were the most frequently counseled components by pharmacists during the simulated interaction. Male patients received better counseling compared to the female patients (t = 6.177; p < 0.0001). Pharmacists with a master of pharmacy degree provided significantly better counseling (f = 3.261; p = 0.042). Many pharmacists (65%) provided hypoglycemia management to patients, however, 63% referred the patient to the physician when the patient experienced hypoglycemia from inappropriate medication administration. Only 2 (7%) pharmacists correctly counseled the patient on all 8 inhaler administration steps. Majority of pharmacists (50%) educated on the role of the rescue and controller therapy in asthma, however, 33% referred the patient to the physician when the patient inquired about controller therapy use. Conclusion Patient counseling was substandard with the majority of community pharmacists focusing on the name of the medication. Pharmacists rarely assessed patient’s medical history or medication use. Disease management and problem solving skills of pharmacists were suboptimal with many referring patients back to the physician.
KeywordsAsthma Community pharmacist Diabetes Patient counseling Qatar Simulated patients
The authors wish to thank Ahmad Alkadour, Fahd Faleh, Hema Thulsidhos, and Manar Salem for devoting their time and effort as simulated patients during the data collection phase of this study.
Funding was made possible by the National Priorities Research Programme award [NPRP 4-254-3-080] from the Qatar National Research Fund (a member of The Qatar Foundation).
Conflicts of interest
- 2.U.S. Food and Drug Administration. The FDA announces new prescription drug information format. http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/LawsActsandRules/ucm188665.htm. Accessed 3 Jan 2016.
- 3.Karapinar-Carkit F, Borgsteede SD, Zoer J, Smit HJ, Egberts AC, van den Bemt PM. Effect of medication reconciliation with and without patient counseling on the number of pharmaceutical interventions among patients discharged from the hospital. Ann Pharmacother. 2009;43:1001–10.CrossRefPubMedGoogle Scholar
- 8.The Omnibus Budget Reconciliation Act of 1990. Pub. L. no. 101–508, 104 Stat 1388, § 4401.Google Scholar
- 9.Ministry of Development Planning and Statistics. http://www.gsdp.gov.qa/portal/page/portal/gsdp_en/statistics_en/Census_en_2. Accessed 3 Jan 2016.
- 11.Kheir N, Zaidan M, Younes H, El Hajj M, Wilbur K, Jewesson PJ. Pharmacy education and practice in 13 Middle Eastern countries. Am J Pharm Edu. 2009;72:1–13.Google Scholar
- 12.Paravattil B. Preceptors’ self-assessment of their ability to perform the learning objectives of an experiential program. Am J Pharm Edu. 2014;76:1–9.Google Scholar
- 17.American Society of Health-System Pharmacists. ASHP guidelines on pharmacist-conducted patient education and counseling. Am J Hosp Pharm. 1997;54:431–4.Google Scholar
- 18.American Society of Consultant Pharmacists. Guidelines for pharmacist counseling of geriatric patients. http://www.ascp.com/resources/policy/upload/Gui98-Counseling%20Ger%20Pat.pdf. Accessed 3 Jan 2016.
- 19.International Pharmaceutical Federation. Counselling concordance communication. https://www.fip.org/files/fip/PI/fip_ipsf_pce_2nd_2012.pdf. Accessed 3 Jan 2016.
- 20.National Association of Pharmacy Regulatory Authorities. Guidelines of counselling. http://napra.ca/Content_Files/Files/PEI/StandardsGuidelines/Guidelines-on-Counseling.pdf. Accessed 3 Jan 2016.
- 21.Pharmaceutical Society of Australia. Professional practice standards 2010. https://www.psa.org.au/download/standards/professional-practice-standards-v4.pdf. Accessed 3 Jan 2016.