Counselling practices in community pharmacies in Riyadh, Saudi Arabia: a cross-sectional study

Abstract

BackgroundCommunity pharmacists play a crucial role in optimising medication use and improving patient outcomes, whilst preventing medication misuse and reducing costs. Evidence suggests that pharmacists counselling improves clinical outcomes, quality of life, drug and disease knowledge and reduces health service utilisation. This study aims to investigate the counselling practices of community pharmacists in Riyadh, the capital of Saudi Arabia.MethodsThe study consisted of two parts: simulated patients (SPs) visits to observe actual counselling practices, and a cross-sectional survey of community pharmacists to assess their reported counselling practices. In the SPs method, there were four scenarios involving four medications. Scenarios 1 and 2 concerned drug–drug interactions, scenario 3 concerned the proper time of administration, and scenario 4 concerned side effects. The simulated visits were conducted between April and May 2012. A four-sections questionnaire was distributed in the same period.ResultsWe conducted 161 simulated visits. Out of the 161 visits a medicine was dispensed in 150 visits. When SPs requested medications, pharmacists asked questions during 15 visits (10.0 %), provided information during 7 visits (4.6 %), and both asked questions and provided information, i.e. provided counselling, during 4 visits (2.6 %). When the SPs started to be inquisitive and demanded information, pharmacists asked SPs questions during 71 visits (47.3 %), provided information during 150 visits (100 %), and both asked questions and provided information, i.e. provided counselling, during 65 visits (43.3 %). Information regarding dose was the most common type of information provided in 146 visits (97.3 %). After the SPs started to be inquisitive and probed for information, only 10 % were counselled on precautions. In the cross-sectional survey, four hundred pharmacists were approached and 350 agreed to participate in the questionnaire (87 % response rate). Of the respondents, 223 (63.7 %) reported that they usually or always tell the patient about the purpose of medicines or the diagnosis, 302 (86.2 %) reported that they usually or always give patient information on how to use or apply the medicine; 299 (85.3 %) said they were satisfied with their counselling practices.ConclusionsThe present study highlights the current deficiencies in appropriate dispensing practices and medication counselling at community pharmacies in Saudi Arabia. Policy makers, stakeholders, and researchers should collaborate to design interventions to improve the current dispensing practices at community pharmacies across the country.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1220-6) contains supplementary material, which is available to authorized users.

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

“…While, for example, barely any information was provided for the criterion ‘side effects’, pharmacies often provided information about the dosage of the medication. Similar differences are also seen in the international literature 6, 7, 16, 28, 30, 31, 41, 42…”

“…Stiftung Warentest, a consumer organisation in Germany, also conducts test purchases at regular intervals and identifies a rather poor quality advisory service 8, 10. This is in no way a problem limited to Germany because such deficiencies in the advice provided in pharmacies are described many times in the international literature 23, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38. On the other hand, there are also a few examples internationally of in part appropriate advisory services provided by pharmacies 39, 40…”

Self-reported and actual involvement of community pharmacists in patient counseling: a cross-sectional and simulated patient study in Gondar, Ethiopia

“…A study done in Turkish Republic of Northern Cyprus revealed that only 73.7% of pharmacists gave dosing instructions to the simulated patients and only 5.9% of the simulated patients were warned by the pharmacists about potential drug and food interactions 15. Similar inconsistencies between self-reported practice of pharmacists and their actual dispensing practice measured using SPs were reported by another study done in Saudi Arabia 16. This discrepancy might be due to pharmacists’ provision of socially desirable responses in the questionnaire and perception of good dispensing practice.…”

“…In a study conducted in Saudi Arabia, being too busy was reported by over half of pharmacists (59.6%) as the barrier for patient counseling 16. However, those factors could not hold priority when checked with the actual situation observed by SP.…”

Development and content validation of an instrument to document the dispensing of prescribed medicines

“…12 Moreover, these services contain a strong cognitive component, which requires the development of clinical reasoning, clinical decision-making and the evaluation of results. 15,16 Thus, defining dispensing work processes and related quality indicators are necessary to ensure the indication, effectiveness, safety and convenience of the use of medicines by patients. 14 However, in some countries, the absence of the medical history of patients in community pharmacies has been identified as a barrier to performing qualified dispensing.…”