The quality of non-prescription medicine counselling in Finnish pharmacies - a simulated patient study

Niina Alastalo; Piia Siitonen; Johanna Jyrkkä; Katri Hämeen-Anttila

doi:10.1016/j.rcsop.2023.100304

The quality of non-prescription medicine counselling in Finnish pharmacies - a simulated patient study

Explor Res Clin Soc Pharm. 2023 Jul 8:11:100304. doi: 10.1016/j.rcsop.2023.100304. eCollection 2023 Sep.

Authors

Niina Alastalo¹, Piia Siitonen¹, Johanna Jyrkkä², Katri Hämeen-Anttila¹

Affiliations

¹ School of Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland.
² Finnish Medicines Agency Fimea, PO Box 55, 00034 Fimea, Kuopio, Finland.

Abstract

Background: Medication counselling provided by pharmacists is important for ensuring the safe use of medicines.

Objective: To assess the quality of non-prescription medicines counselling in Finnish pharmacies.

Methods: Three scenarios using simulated patient methodology were conducted: the patient requesting a specific brand name Burana® (ibuprofen, OTC medicine), Pronaxen® (naproxen, behind-the-counter (BTC) medicine) and a nasal spray. The visits were conducted in 146 pharmacies by trained simulated patients. Each pharmacy was visited twice. The quality of counselling was defined as poor (1-2 points), moderate (3-4 points), or high (5-6 points) based on developed scenario-based scoring criteria.

Results: The total number of conducted visits was 292, of which only 29 received high quality counselling. The quality was high in 20% of the cases for Pronaxen® and in 7% of the cases for Nasal spray scenarios. In the Burana® scenario, counselling quality was high only in 2% of the cases. Patients who requested a nasal spray were often asked questions about their symptoms (93%). In the Pronaxen®-scenario, the most frequently asked questions were related to contraindications and drug interactions (56%). The most often given instructions varied between the scenarios, being follow-up in the Burana® and Nasal spray scenarios (17% and 70%, respectively) and how to use the medicine in the Pronaxen®-scenario (63%).

Conclusions: Non-prescription medicine counselling is rarely performed with high quality. However, the quality of counselling depends on the medication in question. There is room to improve medication counselling and the assessment of the necessity and suitability of treatment, especially when a patient requests an OTC pain medicine by its brand name.

Keywords: Community pharmacy; OTC medicine; Patient counselling; Pharmacist; Quality of medication counselling; Simulated patient.