Mystery shopping and coaching as a form of audit and feedback to improve community pharmacy management of non-prescription medicine requests: an intervention study

Abstract

ObjectivesTo determine whether repeated mystery shopping visits with feedback improve pharmacy performance over nine visits and to determine what factors predict an appropriate outcome.DesignProspective, parallel, repeated intervention, repeated measures mystery shopping (pseudopatient) design.SettingThirty-six community pharmacies in metropolitan Sydney, Australia in March–October 2015.ParticipantsSixty-one University of Sydney pharmacy undergraduates acted as mystery shoppers. Students enrolled in their third year of Bachelor of Pharmacy in 2015 were eligible to participate. Any community pharmacy in the Sydney metropolitan region was eligible to take part and was selected through convenience sampling.InterventionRepeated mystery shopping with immediate feedback and coaching.Outcome measuresOutcome for each given scenario (appropriate or not) and questioning scores for each interaction.ResultsFive hundred and twenty-one visits were analysed, of which 54% resulted in an appropriate outcome. Questioning scores and the proportion of interactions resulting in an appropriate outcome significantly improved over time (P<0.001). Involvement of pharmacists, visit number, increased questioning score and the prescribed scenario were predictors of an appropriate outcome (P=0.008, P=0.022, P<0.001 and P<0.001, respectively). Interactions involving a pharmacist had greater scores than those without (P<0.001).ConclusionsRepeated mystery shopping visits with feedback were associated with improved pharmacy performance over time. Future work should focus on the role of non-pharmacist staff and design interventions accordingly.

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

“…On the other hand, the international literature reports considerable improvements in some cases using various interventions. It is noteworthy, however, that these studies Pharmacology & Pharmacy used considerably more intense interventions in some cases than did the current study, including training [27] [28] [29] and supportive supervision [28], repeated sequential verbal feedback loops [30], distribution of educational pamphlets to pharmacies [31] and implementation and monitoring of guidelines [32] [33]. Therefore it is possible that very minor interventions-such as those used in this study-do not produce any significant improvements whereas (fundamentally) more comprehensive interventions do.…”

“…All the pre-post studies presented above have not explicitly investigated the quality of advice provided for acute diarrhoea in adults over time and are therefore only comparable to this study to a limited degree because the quality of advice depends in part on the particular scenario or the particular indication [30]. A recent Australian pre-post study that explicitly investigated the quality of advice provided for diarrhoea in adults (as 1 of 10 different scenarios) did not report any significant improvement in quality despite repeated feedback loops over time-similar to the present study [30]. Both in the baseline study and the follow-up study, there were considerable differences in the quality of the advice provided depending on the particular criteria investigated.…”

“…This is a key prerequisite for achieving any success with the feedback. There is also no guarantee that the simulated patients in the follow-up study encountered the same pharmacy personnel as in the baseline study, which could also produce distortions in the study results [30].…”

A systematic review of the use of simulated patient methodology in pharmacy practice research from 2006 to 2016

“…An increasing number of studies in community pharmacy across the world use SP methods. For example, Collins et al . used repeated SP visits to assess whether mystery shopping visits, with feedback, improved pharmacy staff's performance.…”

An assessment of counseling quality provided by community pharmacies to patients during expedition of pseudoephedrine

“…Zasadne wydaje się analizowanie, jaki rodzaj działań edukacyjnych kierowanych do personelu aptek przekłada się na poprawę bezpieczeństwa samoleczenia. Fakt, że pracownicy służby zdrowia są gotowi wdrażać mechanizmy naprawcze dopiero w sytuacji wskazania im na nieprawidłowości [29] stanowi przesłankę by wspomnianej edukacji magistrów i techników farmaceutycznych towarzyszyły regularne wizyty "tajemniczego pacjenta" oraz informacja zwrotna [30].…”