Pharmacy counselling models: a means to improve drug use.

BACKGROUND AND OBJECTIVE: Failure to achieve the intended benefit of medical treatment is recognized as an immense problem. The study objective was to examine the usefulness of counselling models containing key questions to facilitate the identification of drug-related problems (DRPs), and to follow up on both pharmacy practitioner and patient experiences. METHODS: Fifty-one pharmacies in Sweden were recruited, along with matching controls. Patients of six therapeutic groups were selected for the counselling model intervention. DRPs were documented in the Swedish DRP database. A telephone follow-up with the patients and a questionnaire survey with the pharmacy practitioners were conducted. An additional follow-up was made in patients sending a representative to pick up their prescribed medications at the pharmacy. RESULTS AND DISCUSSION: In all, 880 DRPs were documented in patients with 8100 prescriptions (10·9%). The DRP documentation rates in study pharmacies were, in general, superior to the control pharmacy rates. DRPs were identified in 24·8% of the non-steroidal anti-inflammation drug (NSAID) patients using a representative to pick up their medications, compared with 9·2% in patients visiting the pharmacy themselves. Of the patients who took part in the follow-up, 94% said that they received suggestions on problem resolution, and twice as many DRPs were reported resolved vs. unresolved. Most patients and pharmacy practitioners were pleased with the new practice. CONCLUSION: The practice of counselling models appears to be a means to improve drug use. More DRPs were found in patients sending a representative to pick up their medications than in patients visiting the pharmacy themselves.

When topical hydrocortisone became an OTC drug in Sweden--a study of the users and their information sources.

On 1 October 1983 hydrocortisone skin ointments in Sweden were declared OTC drugs and were made available without prescription. These preparations, however, were restricted to pharmacy-only sales. The effect of this reform was studied via telephone interviews with samples of customers who had bought hydrocortisone skin ointments, both with and without prescription. The aim of the study was to analyse the reform from the user's point of view. The interviews were conducted at four points in time: before the reform, during the month after the reform, 9 months and 6 years after the change. The total sales of hydrocortisone ointments have increased in the period from 1983 to 1989, both in terms of number of packages and in weight. Most of the background variables of the OTC users did not change over time. However, the percentage of the OTC group who had university education was high at the time of the reform but decreased later. It was found that journal articles were the most frequently used source of information about preparation availability at the time of the reform. However, their importance decreased over time and pharmacy personnel and nurses had become the most important sources 6 years after the reform. Pharmacy personnel had also become the most important source on brand selection and on how to use the preparation 6 years after the reform. An individual tended to use the same source of information about availability, brand selection and how to use the preparation. Those with university education had seen and used written material more often than those without such a background.