Pharmacist intervention in patient selection of nonprescription and self-care products.

OBJECTIVES: To evaluate the potential outcomes of pharmacist intervention on patient selection of nonprescription and self-care products and to evaluate patient confidence and satisfaction with the assistance of the pharmacist. METHODS: A prospective, convenience sample study was conducted at 3 locations of a national supermarket chain pharmacy in the Charlottesville, Virginia, area over 4 months. Patients were recruited for the study if they approached the pharmacy counter and requested assistance with nonprescription and self-care product selection or if the investigating pharmacists approached the patient in the self-care aisles. Men and nonpregnant women age 18 years and older were included in the study. Patients self-selected into the study by agreeing to participate in the study intervention and answering questions relating to their experience with the pharmacist consultation. The study intervention was the pharmacist consultation with the patient to assess the self-care complaint and to make an appropriate recommendation. RESULTS: Forty-two patients participated, the mean (±SD) age was 57 ± 20.8 years, and 62% of patients were female. Sixty percent of patients had used pharmacist help in the past in selecting nonprescription and self-care products. There were 87 total potential outcomes, and a mean of 2.1 potential outcomes per patient. The most potential common outcomes were reduced drug cost, avoided physician visit, corrected product use, and avoided a new prescription. Mean patient confidence (±SD) was 4.38 ± 0.96. Mean patient satisfaction was 4.98. Every patient (100%) stated that they would be more willing to ask for pharmacist help in the future with self-care product selection. The mean encounter time was 6 minutes. CONCLUSION: Pharmacists' active involvement in patient self-care consultation may help patients to select the most effective and safe product and improve patient outcomes. Patients are highly satisfied with pharmacists' help with the selection of nonprescription and self-care products and are more confident with future self-treatment.

State of confusion: sorting out a complex medication regimen for a 79-year-old woman.

Patients with Alzheimer's disease and without caregiver assistance can often have difficulties in managing their medications, which can result in serious consequences. This case study depicts a 79-year-old woman who lives in an assisted living facility and is referred to a geriatric pharmacy specialist in a community pharmacy for a medication review and assistance in medication adherence. During the initial patient visit, the patient was found to have an extremely complex method for managing her medications. She also had multiple medical providers, several duplicate medications, and medications used to treat the adverse effects of other medications. Consequently, this patient had symptoms suggesting she was experiencing medication-induced delirium. This case study illustrates the valuable role of the consultant pharmacist in assisting the patient's medical providers in formulating a simpler and more efficacious medication regimen.

Unraveling multiple complaints in an 82-year-old woman.

With this issue, The Consultant Pharmacist begins a new series, Case Studies in Geriatric Pharmacotherapy. This column will present case studies in which the pharmacist identifies actual or potential patient medication-related problems, presents an evidence-based discussion of options, and develops a patient management plan. As part of this evaluation, the pharmacist consults with both the patient's physicians and family members. Because older individuals generally consume a large number of medications, such a complex, multidisciplinary approach is critical to patient care and one that only pharmacists can provide. The growing consumption of both prescription and over-the-counter drugs by older adults increases the risk of medication-related problems. Pharmacists have an obligation to continually develop skills for identifying, treating, and preventing these medication-related problems.