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Adherence counseling during patient contacts in Swiss community pharmacies

Authors Boeni F, Arnet I, Hersberger KE

Received 18 October 2014

Accepted for publication 23 December 2014

Published 24 April 2015 Volume 2015:9 Pages 597—605

DOI https://doi.org/10.2147/PPA.S76027

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Johnny Chen

Fabienne Boeni, Isabelle Arnet, Kurt E Hersberger

Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland

Purpose: Numerous studies showed the effectiveness of pharmaceutical care in improving medication adherence in primary care patients. However, in daily pharmacy practice, the provision of pharmaceutical care appears to be limited. We aimed at quantifying the content of counseling by community pharmacy staff during patient contacts, especially adherence counseling, and at investigating pharmacist views about their practice of adherence counseling.
Patients and methods: A Master’s student in Pharmacy observed patient contacts at selected community pharmacies in the region of Basel, Switzerland. Content of counseling was manually ticked on a checklist with predefined themes (administration, dose, effect, and adherence). Pharmacists working in the pharmacy were interviewed on triggers, topics, and barriers in adherence counseling.
Results: In 20 community pharmacies and during a total of 148.1 hours, 1,866 patient contacts were observed. During the 1,476 patient contacts including the dispensing of one or more medications, counseling was provided to 799 (54.1%) patients; with 735 (49.8%) patients counseled about administration, 362 (24.5%) about dose, 267 (18.1%) about effect, and 99 (6.7%) about adherence. Significantly more patients received counseling when they obtained prescribed versus over-the-counter medication (P=0.002), a new prescription versus a repeat prescription (P<0.001), or when they were served by a pharmacist versus by another staff member (P<0.001). Of the 33 interviewed pharmacists, all except one reported actively approaching patients for adherence counseling. Triggers included medication-related and patient-related factors. The pharmacists named predominantly product-centered topics of adherence counseling. The most cited barriers were rejection of counseling by the patient and lack of time.
Conclusion: Half of the patients receiving one or more medications were counseled, and only 6.7% of all contacts included adherence counseling. Future studies should clarify how barriers to adherence counseling at the community pharmacy can be overcome.

Keywords: pharmaceutical care, community pharmacy, medication adherence

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