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Assessing the quality of advice-giving about OTC ketoprofen in community pharmacy
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Introdução
O uso indevido de medicamentos pode ter um grande impacto em vários resultados em saúde, tais como a redução da qualidade de vida, a saúde pública e o aumento dos encargos dos cuidados de saúde. Os anti-inflamatórios não esteróides (AINE), sendo um tipo de medicamentos amplamente utilizados e disponíveis, devem ser sempre dispensados tendo em conta todas as suas características e indicações, nomeadamente a sua eficácia, os seus efeitos secundários e assegurando sempre que é a opção correta para o doente em questão. Este aconselhamento deve ser de altamente compreensível, sendo maioritariamente fornecido pelo farmacêutico ou técnico de farmácia em farmácia comunitária.
Independentemente do país de origem do doente e, consequentemente, da sua língua materna, o aconselhamento prestado numa farmácia comunitária deve ser sempre de grande qualidade e, se necessário, ministrado em inglês para garantir a máxima compreensibilidade por parte do mesmo, evitando a utilização indevida e várias complicações relacionadas com o uso de AINEs. O medicamento com um AINE escolhido para este estudo foi o Ketonal Active ®.
Objetivo
Este estudo foi desenvolvido para avaliar a qualidade dos conselhos dados por farmacêuticos e técnicos de farmácia comunitários sobre o cetoprofeno em farmácia comunitária em Cracóvia.
Métodos
A abordagem "Doente Mistério" (MP) foi aplicada a esta investigação. Um cenário e uma lista de verificação correspondente foram utilizados para orientar os MP durante o processo de entrevista, num esforço para replicar, tão próximo quanto possível, um cenário do mundo real. As entrevistas foram realizadas por via telefónica sendo avaliadas em detalhe a qualidade de prestação de aconselhamento acerca do produto em questão e a eficácia com que a pessoa entrevistada aconselhou o MP em inglês. Os resultados foram analisados usando testes ANOVA, testes de Tukey a-posteriori e um gráfico de extremos e quartis.
Resultados
Foram contactadas 79 farmácias para inclusão no estudo, onde a taxa de participação no estudo foi de 51,90% (n=41). 82,93% das entrevistas foram realizadas a pessoas do sexo feminino. 80,99% de todas as entrevistas foram realizadas a pessoas que se identificaram como sendo farmacêuticos. Um dos parâmetros menos bem-sucedidos foi o aconselhamento sobre como tomar a medicação em questão, onde em 78,05% das entrevistas a pessoa entrevistada partilhou informação errada. Um dos parâmetros mais bem-sucedidos das entrevistas foi o aconselhamento acerca da quantidade de medicamento tomar, onde 63.41% dos entrevistados dram informação correta sem a necessidade de serem questionados acerca do assunto.
Discussão
Com base nos resultados do estudo, podemos concluir que os farmacêuticos/técnicos de farmácia tinham os conhecimentos técnicos necessários para informar os doentes sobre o Ketonal Active ® e podiam explicar várias ideias-chave sobre a maioria dos aspetos relacionados com o medicamento em questão, incluindo informação sobre como administrar o medicamento, a sua eficácia e efeitos secundários, e fornecer aconselhamento apropriado sobre várias outras recomendações adicionais relativas à terapêutica anti-inflamatória.
Os resultados podem também sugerir que a maioria do pessoal da farmácia que foi entrevistado tem a capacidade de comunicar eficazmente em inglês, embora possa não ter a destreza linguística e confiança necessária para reformular os seus conselhos e, como resultado, não perguntar se a informação dada foi compreendida pelo doente.
Conclusão
Os farmacêuticos/técnicos de farmácia entrevistados detinham o conhecimento apropriado sobre o Ketonal Active ® de forma a explicar aspetos importantes sobre a toma do mesmo. No entanto, é necessário apostar na formação contínua e pós-graduada focada em aspetos relacionados com o aconselhamento adequado de todo o tipo de medicamentos, principalmente medicamentos não sujeitos a receita médica. Conclui-se também que o nível de inglês do farmacêutico/técnico de farmácia tem uma forte correlação com a qualidade do aconselhamento prestado.
The misuse of medication can greatly impact several health-related outcomes, such as reduced quality of life, public health issues and increased health care costs burdens. NSAID’s, being a widely used and available type of medication, should always be dispensed bearing in mind all characteristics and indications, such as its effectiveness and side effects and always assuring it is the correct medication for the patient requesting it. This advice should be of high-quality, understandable, and is mostly provided by the pharmacist or pharmacy technician at a community pharmacy. Regardless of a patient’s country of origin and, consequently, mother-tongue, advice provided at a community pharmacy setting should always be of great quality and, if needed, handed out in English to ensure maximum understandability by the patient, avoiding misusages and other related complications regarding the use of NSAID’s. The chosen NSAID for this study was Ketonal Active ®. Aim This study was developed to assess the quality of advice given by community Pharmacists and Pharmacy Technicians about ketoprofen at a community pharmacy setting in Krakow. Methods The "Mystery Patient" (MP) approach was applied to this investigation. A scenario and corresponding checklist were utilized to direct the Mystery Patient's (MP) during the interviewing process to replicate, as closely as feasible, a real-world scenario. The interviews were carried out over the telephone and both the quality of advice provided on the product in question as well as the effectiveness with which the person interviewed advised the MP on this matter considering their attitude towards the MPs and their communicating ability in English. The results were analyzed using ANOVA tests, Tukey's post-hoc test, and a box and whiskers plot. Results 79 pharmacies were contacted for inclusion in the study, where the study participation rate was 51.90% (n=41). 82.93% of the interviews were conducted to female individuals. 80.99% of all interviews were conducted to people who identified themselves as pharmacists. One of the least successful parameters was advice on how to take the medication in question, where in 78.05% of the interviews the person interviewed shared wrong information. One of the most successful parameters of the interviews was the advice about how much medication to take, where 63.41% of the interviewee’s dram correct information without the need to be asked about it. Discussion Based on the study's findings, we can conclude that the pharmacists/pharmacy technicians had the necessary knowledge to infom patients about of Ketonal Active ® and could explain several key ideas on most aspects of the drug, including information on how to administer the medication, its efficacy and side effects, and were able to provide appropriate counseling on several other additional recommendations regarding anti-inflammatory therapy. Our findings may also suggest that most of the pharmacy staff members who were interviewed have the ability to communicate effectively in English but may lack the confidence to rephrase their advice and, as a result, fail to inquire as to whether the information given was understood by the recipient. Conclusion The pharmacists/pharmacy technicians interviewed had the appropriate knowledge about Ketonal Active ® to explain important aspects of taking it. Most pharmacies did not correctly advise on the effectiveness and adverse reactions associated with this therapy and did not correctly identify the need to refer the patient to a medical consultation after the call. It can also be concluded that the level of English of the pharmacist/pharmacy technician has a strong correlation with the quality of the advice given. However, it is necessary to invest in continuous and post-graduate training focused on aspects related to the proper counseling of all kinds of medicines, especially non-prescription medicines.
The misuse of medication can greatly impact several health-related outcomes, such as reduced quality of life, public health issues and increased health care costs burdens. NSAID’s, being a widely used and available type of medication, should always be dispensed bearing in mind all characteristics and indications, such as its effectiveness and side effects and always assuring it is the correct medication for the patient requesting it. This advice should be of high-quality, understandable, and is mostly provided by the pharmacist or pharmacy technician at a community pharmacy. Regardless of a patient’s country of origin and, consequently, mother-tongue, advice provided at a community pharmacy setting should always be of great quality and, if needed, handed out in English to ensure maximum understandability by the patient, avoiding misusages and other related complications regarding the use of NSAID’s. The chosen NSAID for this study was Ketonal Active ®. Aim This study was developed to assess the quality of advice given by community Pharmacists and Pharmacy Technicians about ketoprofen at a community pharmacy setting in Krakow. Methods The "Mystery Patient" (MP) approach was applied to this investigation. A scenario and corresponding checklist were utilized to direct the Mystery Patient's (MP) during the interviewing process to replicate, as closely as feasible, a real-world scenario. The interviews were carried out over the telephone and both the quality of advice provided on the product in question as well as the effectiveness with which the person interviewed advised the MP on this matter considering their attitude towards the MPs and their communicating ability in English. The results were analyzed using ANOVA tests, Tukey's post-hoc test, and a box and whiskers plot. Results 79 pharmacies were contacted for inclusion in the study, where the study participation rate was 51.90% (n=41). 82.93% of the interviews were conducted to female individuals. 80.99% of all interviews were conducted to people who identified themselves as pharmacists. One of the least successful parameters was advice on how to take the medication in question, where in 78.05% of the interviews the person interviewed shared wrong information. One of the most successful parameters of the interviews was the advice about how much medication to take, where 63.41% of the interviewee’s dram correct information without the need to be asked about it. Discussion Based on the study's findings, we can conclude that the pharmacists/pharmacy technicians had the necessary knowledge to infom patients about of Ketonal Active ® and could explain several key ideas on most aspects of the drug, including information on how to administer the medication, its efficacy and side effects, and were able to provide appropriate counseling on several other additional recommendations regarding anti-inflammatory therapy. Our findings may also suggest that most of the pharmacy staff members who were interviewed have the ability to communicate effectively in English but may lack the confidence to rephrase their advice and, as a result, fail to inquire as to whether the information given was understood by the recipient. Conclusion The pharmacists/pharmacy technicians interviewed had the appropriate knowledge about Ketonal Active ® to explain important aspects of taking it. Most pharmacies did not correctly advise on the effectiveness and adverse reactions associated with this therapy and did not correctly identify the need to refer the patient to a medical consultation after the call. It can also be concluded that the level of English of the pharmacist/pharmacy technician has a strong correlation with the quality of the advice given. However, it is necessary to invest in continuous and post-graduate training focused on aspects related to the proper counseling of all kinds of medicines, especially non-prescription medicines.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2022, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
NSAID’s Community pharmacy Counselling Ketoprofen Mestrado integrado - 2022