Assessment of counselling for acute diarrhoea in German pharmacies: a simulated patient study†

Abstract

ObjectivesThe aim of this study was to assess the quality of counselling provided for acute diarrhoea and to evaluate the role of the patient's approach and different user groups in determining the outcome of counselling.MethodsThe simulated patient methodology was used in all 21 community pharmacies in a north‐eastern German city. Four different scenarios related to self‐medication of acute diarrhoea were developed and used in all the pharmacies (a total of 84 visits). The assessment form, completed immediately postvisit by the simulated patient, included 9 objective items scored using dichotomous scales to produce a scale from 0 to 9. After evaluating the data, every pharmacy received individual performance feedback to encourage behavioural changes and improve the quality of the counselling provided.Key findingsOverall, the quality of counselling was poor (mean score of 3.3/9 (37%)). The most common information provided was about dosage (87% of interactions), while the least common information given was about side effects (4% of interactions). The main effect was seen when comparing the product and symptom requests (F(1,60) = 24.748, P < 0.001, ωp 2 = 0.277). There was no effect resulting from different user groups (F(1,28) = 0.237, P = 0.630, ωp 2 = −0.026) and no interaction between the type of request and different user groups (F(1,28) = 3.395, P = 0.076, ωp 2 = 0.073).ConclusionsThis study highlighted the current deficits in appropriate counselling provided by community pharmacies in Germany.

Assessment of Counselling for Acute Diarrhoea in North-Eastern German Pharmacies—A Follow-Up Study Using the Simulated Patient Methodology

“…It is particularly important for the validity of the study results to ensure that there is minimal distortion in the comparison between the baseline study [14] and the follow-up study. Great importance was therefore placed on not changing the study design as far as possible compared to 2014.…”

“…To ensure comparability, all four test scenarios from the baseline study were carried out in an absolutely identical way in the follow-up study. The assessment form, which was also identical to that used in 2014, was completed immediately after the test purchases were made by the simulated patients and included 9 objective criteria, fulfilment of which was measured exclusively using dichotomous scales [14]. The test purchases were again covert, that is, they were conducted without informing the particular pharmacy beforehand, analogous to the baseline study and other international studies [17].…”

“…Both the pre-tests and the test purchases were conducted in the same way as for the baseline study [14]. The distribution of the pharmacies being tested to the particular test buyer was also identical to 2014 and once again it was ensured that no pharmacy was visited more than once by a test buyer to minimise the risk of exposure.…”

“…For Germany, the quality of advice provided by pharmacies for acute diarrhoea in adults was examined for the first time in 2014 by Langer et al and significant shortcomings were identified [14]. The simulated patient methodology used is a well-tested approach for revealing any weak points [15].…”

The Quality of Counselling for Oral Emergency Contraceptive Pills—A Simulated Patient Study in German Community Pharmacies

“…Unlike the many studies conducted in other countries [ 21 , 23 , 30 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ], in Germany, there have not been any investigations to date on the counselling and dispensing of an emergency contraceptive pill using an SPM approach because the few scientific SP studies available for Germany on the counselling quality in pharmacies are always based on indications other than emergency contraception. Clear deficits in the quality of counselling have been identified in these studies [ 46 , 47 , 48 , 49 , 50 , 51 ].…”