Exploring the supply of non-prescription medicines from community pharmacies in Scotland

Abstract

Objective: The objectives of this study were to: (1) explore pharmacy support staff (PSS) opinions of and attitudes towards the supply of non-prescription medicines (NPMs); (2) assess whether NPM supply is compliant with professional and good practice guidelines.

Methods: This exploratory study was conducted in community pharmacies in Grampian, Scotland, and comprised non-participant observation of NPM consultations, semi-structured interviews with, and a questionnaire of, PSS. Guideline compliance was assessed by a consensus group of practising community pharmacists.

Main outcome measures: The percentage of consultations which achieved compliance with professional guidelines was calculated. A total score was also calculated for each consultation to assess compliance with good practice guidelines.

Results: Fifty-seven support staff from 21 pharmacies participated in at least one component of the study. In total, 195 observed consultations were evaluable. Fifty-four participants completed a questionnaire and 95 post-consultation interviews were completed. Most consultations involved product requests and were for self-treatment. Overall, interviewees were satisfied or very satisfied with 78 (83.0%) and 14 (14.9%) of all consultations, respectively. Participants' self-reported scores for the quality of consultation were high indicating that they perceived their consultations to be appropriate. Most PSS were aware of good practice guidelines and thought their use was important/very important, yet few consultations were fully guideline compliant. Non-product consultations were more guideline compliant than product consultations. Just over one third (35.6%) of consultations established whether other medication was being used by the intended recipient of the NPM. Few PSS (21.2%) had read the professional guidelines and as such, compliance with these guidelines was extremely low. The percentage of guideline compliant consultations were 6.6% (n = 5) (sufficient information gathered), 13.2% (n = 10) (adequate advice/information provision), 46.1% (n = 35) (personal involvement of pharmacist), 21.1% (n = 16) (particular care of specific patient groups) and 28.9% (n = 22) (pharmacist involvement with specific NPMs).

Conclusion: Few consultations for NPMs in this study were fully guideline compliant. The reasons for non-compliance with good practice and professional guidelines need to be explored. Although failure to comply with professional guidelines could be due to PSS's lack of awareness, this does not explain non-compliance with good practice guidelines.