Die Beratungsqualität von Apotheken bei akutem Durchfall – Eine Analyse unter Verwendung der „Simulated Patient“-Methode

Langer, Bernhard; Bull, Elisa; Burgsthaler, Tina; Glawe, Julia; Schwobeda, Monique; Simon, Karen Muriel

doi:10.1016/j.zefq.2016.02.001

Cited by 13 publications

(11 citation statements)

References 10 publications

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“…This study is part of a larger research project. Unlike previously published research results, differentiating by different user groups does not play a role due to the objectives of this study, and for this reason the scenarios were only differentiated by the patient’s approach 19-21. This means that in the analysis the test purchases were differentiated into 42 medication-based (test scenarios 1 and 3) or 42 symptom-based (test scenarios 2 and 4) test purchases.…”

Section: Methodsmentioning

confidence: 87%

“…To avoid the Hawthorne effect and to ensure the most realistic possible consultation situation, the test purchases took place without first informing the pharmacies included in the investigation in accordance with other national and international studies 19-21,30-33…”

Section: Methodsmentioning

confidence: 99%

“…The economic aspects of providing good advice, because dispensing comparably expensive medications (without appropriate additional benefits) constitutes poor advice from the customer’s perspective. This practice can be considered unethical and a poor business practice as it does not facilitate the building of good relationships that would create repeat customers.Whether the issues indicated differ based on the patient’s approach (medication-based versus symptom-based query) because to date it has only been reported anecdotally that more expensive medications were dispensed more often in symptom-based scenarios than in medication-based scenarios 19 …”

Section: Introductionmentioning

confidence: 99%

“…Whether the issues indicated differ based on the patient’s approach (medication-based versus symptom-based query) because to date it has only been reported anecdotally that more expensive medications were dispensed more often in symptom-based scenarios than in medication-based scenarios 19…”

Section: Introductionmentioning

confidence: 99%

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Medication dispensing, additional therapeutic recommendations, and pricing practices for acute diarrhoea by community pharmacies in Germany: a simulated patient study

Langer¹,

Kunow²

2019

Pharm Pract (Granada)

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Background:In Germany over-the-counter medications (OTC) – which since 2004 are no longer subject to binding prices – can only be purchased in pharmacies. Pharmacy owners and their staff therefore have a special responsibility when dispensing, advising on and setting the prices of medications.Objective:The aim of this study was to assess medication dispensing, additional therapeutic recommendations and pricing practices for acute diarrhoea in adults and to evaluate the role of the patient’s approach (symptom-based versus medication-based request) in determining the outcome of these aspects.Methods:A cross-sectional study was conducted from 1 May to 31 July 2017 in all 21 community pharmacies in a medium-sized German city. Symptom-based and medication-based scenarios related to self-medication of acute diarrhoea were developed and used by five simulated patients (SPs) in all of the pharmacies (a total of 84 visits). Differentiating between the different test scenarios in terms of the commercial and active ingredient names and also the prices of the medications dispensed, the SPs recorded on collection forms whether the scenario involved generic products or original preparations as well as whether recommendations were made during the test purchases regarding an additional intake of fluids.Results:In each of the 84 test purchases one preparation was dispensed. However, a preparation for oral rehydration was not sold in a single test purchase. On the other hand, in 74/84 (88%) of test purchases, medications with the active ingredient loperamide were dispensed. In only 35/84 (42%) of test purchases, the patient was also recommended to ensure an ‘adequate intake of fluids’ in addition to being dispensed a medication. In symptom-based scenarios significantly more expensive medications were dispensed compared to the medication-based scenarios (Wilcoxon signed rank test: z = -4.784, p < 0.001, r = 0.738). Also within the different scenarios there were enormous price differences identified – for example, in the medication-based scenarios, even for comparable loperamide generics the cheapest preparation cost EUR 1.99 and the most expensive preparation cost EUR 4.53.Conclusions:Oral rehydration was not dispensed and only occasionally was an adequate intake of fluids recommended. There were also enormous price differences both between and within the scenarios investigated.

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Section: Methodsmentioning

confidence: 87%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Medication dispensing, additional therapeutic recommendations, and pricing practices for acute diarrhoea by community pharmacies in Germany: a simulated patient study

Langer¹,

Kunow²

2019

Pharm Pract (Granada)

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“…An important prerequisite for providing adequate advice is again an appropriate training. This could, for example, include more rigorous teaching and evaluating of patient and customer consultations using examples to improve qualifications for consultations [38], especially as to date teaching such "soft skills" in German universities is currently below average compared to Europe as a whole [39].…”

Section: Discussionmentioning

confidence: 99%

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

Langer¹,

Kieper²,

Laube³

et al. 2018

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Aim: As the primary aim of this study, we analysed whether the quality of advice provided by pharmacies in the period between 2014 (baseline study) and 2017 (follow-up study) could actually be increased using a single written performance feedback given to each pharmacy in 2014. The secondary aim of the follow-up examination was to analyse whether the quality of advice differed depending on the professional group providing the advice. Methodology: To ensure the least possible distortion in the comparison between the baseline and the follow-up studies, the study design used for the follow-up examination in 2017 was not changed compared to the baseline examination in 2014. The data for the follow-up examination were therefore collected using the simulated patient method in all 21 pharmacies in a city in the northeast of Germany. Three female and two male test buyers used four different scenarios for self-medication of acute diarrhoea in all of the pharmacies (a total of 84 test purchases). Results: There were significant differences between the overall results from the baseline study (2014) and the follow-up study (2017) (Wilcoxon signed rank test; z = −2.065, p = 0.039, r = 0.225). In the overall average, the pharmacies in 2017 achieved only 2.7 (30%) of 9 possible points whereas in 2014 they achieved 3.3 (37%). The quality of advice between the professional groups did not show any significant differences (Kruskal-Wallis test: χ 2 (2) = 1.946; p = 0.378, r = 0.027). Conclusions: The quality of advice for acute diarrhoea in adults declined over time. A written performance feedback intended to improve the quality proved ineffective. Interventions with a far greater impact are required to achieve an improvement in the quality of advice provided.

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Counselling with a focus on product and price transparency for over‐the‐counter headache medicines: A simulated patient study in community pharmacies in Munich, Germany

Langer,

Kunow,

Bolduan

et al. 2024

Health Planning & Management

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BackgroundIn Germany, over‐the‐counter (OTC) medicines may only be dispensed by community pharmacies (CPs). German CPs must ensure ‘adequate’ counselling, including the cost of medicines. Along with information gathering and advice giving as classic aspects of counselling, the aim was also to investigate counselling indicators of product and price transparency.MethodsThe cross‐sectional study was based on the covert simulated patient (SP) methodology and was conducted in a random sample of CPs stratified by districts in the major German city of Munich. Each of the 178 selected CPs was visited once by one of five trained female students. They simulated a symptom‐based sub‐scenario 1 with a request for an OTC medicine for a headache and a sub‐scenario 2 with standardised information regarding product and price transparency. The assessment, completed immediately postvisit by the SPs, included a total of 23 items.ResultsAll 178 scheduled visits were completed successfully. The median counselling score with the classic items was 3.0 out of 12 points (interquartile range [IQR] 4.25) and when expanded by items for product and price transparency the score was 4.0 out of 14 points (IQR 4.00). A selection of medicines was offered unsolicited in 38.2% of the visits and in 5.6% of the visits voluntary price information was provided before the transaction. A request for a cheaper medicine led to a significant price reduction (Wilcoxon signed‐rank test; p < 0.001, r = 0.869).ConclusionDue to the below‐average level of counselling, the regional chambers of pharmacists are recommended to initiate measures for improvement. There is also potential for optimisation with regard to product and price transparency as an important extension of the classic counselling aspects. It is therefore recommended that the government raise customers' awareness of the cost of medicines.

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Die Beratungsqualität von Apotheken bei akutem Durchfall – Eine Analyse unter Verwendung der „Simulated Patient“-Methode

Cited by 13 publications

References 10 publications

Medication dispensing, additional therapeutic recommendations, and pricing practices for acute diarrhoea by community pharmacies in Germany: a simulated patient study

Medication dispensing, additional therapeutic recommendations, and pricing practices for acute diarrhoea by community pharmacies in Germany: a simulated patient study

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

Counselling with a focus on product and price transparency for over‐the‐counter headache medicines: A simulated patient study in community pharmacies in Munich, Germany

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