Background Counseling has become an integral part of community pharmacy practice. Previous reviews of research into pharmacists' counseling practices on prescription medicines have primarily focused on activities at a national level. None have adopted an international perspective. Objectives To review (1) verbal counseling rates and (2) types of information provided for prescription medicines in community pharmacies and (3) to compare the research methods used in evaluating counseling practice. Methods Published articles in English (1993-2007) were identified based on searches of on-line databases (International Pharmaceutical Abstracts, PubMed, Medline, EMBASE, CINAHL, and Cochrane Database of Systematic Reviews) and cited references in the articles. Results Forty research articles met inclusion criteria for studies investigating verbal counseling rates and/or types of information provided for prescription medicines in community pharmacies. The counseling rates reported varied from 8% to 100%, depending on the research methods used. On average, lower counseling rates were found from consumer and observational studies compared with pharmacist- and simulated-patient studies. The type of prescription also influenced the rate. Higher rates were found in counseling consumers with new compared with regular prescriptions. Information on directions for use, dose, medicine name, and indications was more frequently given than information on side effects, precautions, interactions, contraindications, and storage. Most findings came from self-report and observational methods, each of which has limitations. Few studies used triangulation to overcome methodological limitations. In recent studies, simulated-patient methods have been used increasingly to evaluate counseling practice in the natural environment. Conclusions The actual counseling rates are difficult to obtain due to the differences and limitations of each research method. Of all methods, simulated-patient methods appear to be a more reliable method of evaluating counseling practice in pharmacies. In providing information to consumers with prescriptions, pharmacists appear to have fulfilled the minimum legislative requirements or practice standards.

A review of counseling practices on prescription medicines in community pharmacies.

Evaluation of a novel educational strategy, including inhaler-based reminder labels, to improve asthma inhaler technique.

Aim of the review The aim of this review is to conduct an in-depth analysis of the available literature in order to identify and evaluate studies measuring patient satisfaction with pharmacy services delivered by pharmacists in a community setting Method An extensive literature search was conducted in five databases (Medline, Scopus, Embase, Psychinfo, International Pharmaceutical Abstracts) using the search terms “patient/client/consumer satisfaction” AND “community pharmacy/pharmacies” AND “pharmacy service/pharmaceutical services/pharmacy program/intervention/intervention studies” Only those articles where the main focus was measuring patient satisfaction with services delivered in community pharmacies were included in the review Patient satisfaction was explored with three different levels of pharmacy services—general services, intervention services and cognitive services Results Twenty-four articles measuring patient satisfaction with community pharmacy services were retrieved Of these, eleven measured patient satisfaction with general services, six measured satisfaction with intervention services and seven measured satisfaction with cognitive services The majority of studies reviewed had adopted and measured satisfaction as a multidimensional construct None of the studies reviewed tested any theoretical models of satisfaction Further a lack of consistent instruments measuring patient satisfaction was observed, with most of the reviewed studies using self developed, non-validated or ad hoc instruments with items from various previously published papers The review also observed high levels of patient satisfaction with pharmacy services be they general, intervention or cognitive services Conclusion This review found that patient satisfaction has been measured within the community pharmacy context to a certain degree Further research is needed to develop and test instruments based on theoretical frameworks, to test satisfaction pre and post hoc and in well designed randomized controlled trials and to measure changes in satisfaction over time Novel approaches involving an understanding of expectations and preferences of patients and matching these to the services provided also need to be explored

Measurement of patient satisfaction with community pharmacy services: a review

Objectives
This study will provide guiding information about the population perception, views and satisfaction with pharmacist’s performance as health care provider in the community pharmacy setting in Riyadh, Saudi Arabia.

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Patients' Perception, Views and Satisfaction With Pharmacists' Role as Health Care Provider in Community Pharmacy Setting at Riyadh, Saudi Arabia

Optimal effects of asthma medications are dependent on correct inhaler technique. In a telephone survey, 77/87 patients reported that their Turbuhaler technique had not been checked by a health care professional. In a subsequent pilot study, 26 patients were randomized to receive one of 3 Turbuhaler counseling techniques, administered in the community pharmacy. Turbuhaler technique was scored before and 2 weeks after counseling (optimal technique = score 9/9). At baseline, 0/26 patients had optimal technique. After 2 weeks, optimal technique was achieved by 0/7 patients receiving standard verbal counseling (A), 2/8 receiving verbal counseling augmented with emphasis on Turbuhaler position during priming (B), and 7/9 receiving augmented verbal counseling plus physical demonstration (C) (Fisher's exact test for A vs C, p = 0.006). Satisfactory technique (4 essential steps correct) also improved (A: 3/8 to 4/7; B: 2/9 to 5/8; and C: 1/9 to 9/9 patients) (A vs C, p = 0.1). Counseling in Turbuhaler use represents an important opportunity for community pharmacists to improve asthma management, but physical demonstration appears to be an important component to effective Turbuhaler training for educating patients toward optimal Turbuhaler technique.

http://rc.rcjournal.com/content/respcare/50/5/617.full.pdf

Counseling about turbuhaler technique: needs assessment and effective strategies for community pharmacists.

Objective To assess the level of expectation and satisfaction of patients with asthma regarding the counseling provided by community pharmacists, and to identify the counseling information patients consider important in helping them manage their asthma. Design Mailed survey. Participants: 208 patients seen in the University of Utah Asthma Clinic for at least 3 months, age 18 years or older, and on at least 1 asthma medication. Main Outcome Measures: Frequency of pharmacist-provided asthma medication counseling, patients' perception of the importance of counseling, and their satisfaction with counseling. Results: Response rate was 55% (106 of 194 surveys returned). The majority of patients (> 90%) indicated that their community pharmacist "never" or "sometimes" discussed the management of their asthma with them. Frequency of counseling in three predefined areas of asthma education (role of medications, inhaler technique, and prevention of asthma attacks) was 1.91, 1.72, and 1.31, respectively (1=never, 4=always). Most patients (76%) considered these areas of counseling to be important for the management of their asthma. Most patients (62%) were "somewhat" to "pretty" satisfied with the type and amount of asthma counseling provided by their pharmacist. Counseling sessions averaged less than 3 minutes. Only 25% of patients would be willing to pay an additional amount for pharmaceutical care. Conclusion: Self-reported rates of patient counseling concerning asthma medications in the community pharmacy setting are low and adequately address neither the educational needs of patients nor the recommendations of the National Asthma Education and Prevention Program.

Joseph C. Veltri

Papers

Asthma patients' satisfaction with the frequency and content of pharmacist counseling.