Factors associated with the pharmacist counselling without dispensing.

PURPOSE: To describe the pharmacist counselling without dispensing and to analysed the characteristics of pharmacies and pharmacists that provide this type of counselling, and the characteristics of customers that receive it to a greater extent. METHODS: We carried out a cohort study on a sample of 166 pharmacists in North West Spain. Different characteristics of pharmacists and clients and other variables related to counselling were measured (who initiates the consultation; type of consultation; whether or not the patient consulted with a doctor previously and who is the receptor of the counselling) were included in the models as independent variables. Pharmacist Counselling without dispensing (PhCwD) were included as dependent variable. We constructed logistic regression models. RESULTS: The response rate to the first questionnaire was 98.8% and the participation rate in the follow-up was 60%. Out of 7010 registered pharmacist counselling, 6034 were included in the final analysis (86.1%). The proportion of PhCwD is 26.3% (95%IC: 25.2-27.4). CONCLUSIONS: Our results show the number of working hours of the pharmacist and the amount of customers are associated with PhCwD. So working hours and amount customers should be reduced. Other factor that should be taken into account is the fact that pharmacists with less experience should give less counsels. Thus during the university period pharmacist counselling should be studied. Finally, our results show that an important proportion of counselling is given regardless the dispensation process, and this should be taken into account when defining the pharmacists remuneration system.

Influence of pharmacists' opinions on their dispensing medicines without requirement of a doctor's prescription.

OBJECTIVE: To assess the influence of pharmacists' opinions on their dispensing medicines with a "medical prescription only" label without requiring a doctor's prescription. METHODS: We performed a cross-sectional study of 166 community pharmacies in northwest Spain. The opinions of pharmacists on the following were collected as independent variables through personal interview: a) physicians' prescribing practices; b) the pharmacist's qualifications to prescribe; c) the responsibility of the pharmacist regarding the dispensed drugs; d) the customer' qualifications for self-medication; and e) the pharmacist's perception of his or her own work. The dependent variable was the pharmacist's demand for a medical prescription for 5 drugs, which in Spain require a prescription. Multiple linear regression models were constructed. RESULTS: The response rate was 98.8%. A total of 65.9% of pharmacists reported dispensing antibiotics without a prescription. This percentage was 83.5% for nonsteroidal anti-inflammatory drugs, 46.3% for angiotensin-converting enzyme inhibitors, 13.4% for benzodiazepines, and 84.8% for oral contraceptives. Further results showed that pharmacists with a heavier workload and those who underestimated the physicians' qualifications to prescribe but overestimated their own qualifications to prescribe less frequently demanded medical prescriptions. In contrast, pharmacists who stressed the importance of their duty in rationalizing the consumption of drugs more frequently demanded medical prescriptions. CONCLUSION: Our results suggest that to increase the quality of dispensing: a) the importance of the pharmacist's duty in controlling drug consumption should be stressed; b) pharmacies' workload should be optimized; and c) perceptions of physicians' prescribing practices among pharmacists should be improved.

Influence of pharmacists’ opinions on their dispensing medicines without requirement of a doctor’s prescription

Objetivo: Evaluar la influencia de las opiniones de los farmacéuticos que no solicitan receta médica para dispensar fármacos que la requieren para su venta. Métodos: Se ha llevado a cabo un estudio transversal sobre una muestra de 166 farmacéuticos de oficina de farmacia en la provincia de A Coruña. Las opiniones de los farmacéuticos, variables e independientes, fueron medidas mediante entrevista personal. Se valoraron las opiniones siguientes: a) prácticas prescriptoras de los médicos; b) cualificación de los farmacéuticos para prescribir; c) la responsabilidad de los farmacéuticos sobre los medicamentos dispensados; d) la cualificación de los clientes para automedicarse, y e) la percepción de los farmacéuticos sobre su trabajo. La exigencia de receta por parte del farmacéutico para 5 fármacos, que en España deben dispensarse con receta, fue la variable dependiente que se tuvo en cuenta. Se construyeron modelos de regresión múltiple. Resultados: La participación fue del 98,8%. Un total del 65,9%de los farmacéuticos afirmaron dispensar antibióticos sin receta. Este porcentaje fue del 83,5% para los antiinflamatorios no esteroideos, 46,3% para los inhibidores de la enzima de conversión de la angiotensina, 13,4% para las benzodiazepinas y 84,8% para los anticonceptivos orales. Además, los resultados muestran que los farmacéuticos con mayor carga de trabajo y los que califican peor la prescripción de los médicos, y que en mayor medida consideran que ellos mismos están capacitados para prescribir, exigen menos recetas médicas. Por el contrario, los farmacéuticos que otorgan mayor importancia a la racionalización en el consumo de fármacos exigen receta más frecuentemente. Conclusión: Nuestros resultados indican que para el incremento en la calidad de la dispensación el sistema debería lograr: a) incrementar la importancia que los farmacéuticos otorguen al control y la racionalización del consumo de fármacos; b) adecuar la carga de trabajo de las farmacias, y c) mejorar la percepción que los farmacéuticos tienen de las pautas prescriptoras de los médicos

Objective: To assess the influence of pharmacists’ opinions on their dispensing medicines with a «medical prescription only» label without requiring a doctor’s prescription. Methods: We performed a cross-sectional study of 166 community pharmacies in northwest Spain. The opinions of pharmacists on the following were collected as independent variables through personal interview: a) physicians’ prescribing practices; b) the pharmacist’s qualifications to prescribe; c) there sponsibility of the pharmacist regarding the dispensed drugs; d) the customer’ qualifications for self-medication; and e) the pharmacist’s perception of his or her own work. The dependent variable was the pharmacist’s demand for a medical prescription for 5 drugs, which in Spain require a prescription. Multiple linear regression models were constructed. Results: The response rate was 98.8%. A total of 65.9% of pharmacists reported dispensing antibiotics without a prescription. This percentage was 83.5% for non-steroidal anti-inflammatory drugs, 46.3% for angiotensin-converting enzyme inhibitors, 13.4% for benzodiazepines, and 84.8% for oral contraceptives. Further results showed that pharmacists with a heavier workload and those who under estimated the physicians’ qualifications to prescribe but overestimated their own qualifications to prescribe less frequently demanded medical prescriptions. In contrast, pharmacists who stressed the importance of their duty in rationalizing the consumption of drugs more frequently demanded medical prescriptions. Conclusion: Our results suggest that to increase the quality of dispensing: a) the importance of the pharmacist’s duty in controlling drug consumption should be stressed; b) pharmacies ’workload should be optimized; and c) perceptions of physicians’ prescribing practices among pharmacists should be improved

Factors related with prescription requirement to dispense in Spain.

PURPOSE: To identify factors associated with prescription requirement to dispense. METHODS: We carried out a cross-sectional study on a sample of 166 pharmacists in North-West Spain. The following independent variables were collected through a personal interview: pharmacist's education and speciality, characteristics of the pharmacy, and its socio-economic environment. We constructed multiple regression models using as dependent variables: requirement of prescription to dispense five drugs which have to be dispensed with a prescription; and opinion on whether a prescription should be required to dispense these drugs. RESULTS: The response rate was 98.8%. A proportion of 65.9% of pharmacists dispense antibiotics without any prescription. This proportion is 83.5% for nonsteroidal anti-inflammatory drugs, 46.3% for ACE inhibitors, 13.4% for benzodiazepines and 84.8% for oral contraceptives. A higher requirement prescription was found to be associated with the antecedent of a speciality training of the pharmacist (p = 0.028) and his or her age (p < 0.001). A low prescription requirement is associated with the condition of being owner of the pharmacy (p = 0.032), with a high economic level of the population attended (p = 0.016) and with the size of the pharmacy (p = 0.045). CONCLUSIONS: The proportion of pharmacists who dispense drugs without a prescription is extremely high. Our results suggest that in order to increase quality of dispensing, it is necessary to increase pharmacist education and direct efforts of awareness primarily at pharmacists in charge, who are young and work in large pharmacies.