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Proper Counseling and Dispensing of Isotretinoin Capsule Products by Community Pharmacists in UAE: A Simulated Patient Study

Authors Rashid ZA, Al-Tabakha MM, Alomar MJ

Received 31 March 2020

Accepted for publication 30 May 2020

Published 16 June 2020 Volume 2020:13 Pages 405—414


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Jeffrey Weinberg

Zainab A Rashid,1 Moawia M Al-Tabakha,2 Muaed Jamal Alomar1

1Department of Clinical Sciences, College of Pharmacy & Health Sciences, Ajman University, Ajman, United Arab Emirates; 2Department of Pharmaceutical Sciences, College of Pharmacy & Health Sciences, Ajman University, Ajman, United Arab Emirates

Correspondence: Moawia M Al-Tabakha
Ajman University, Ajman, United Arab Emirates
Tel +971 67482222
Fax +971 67438888

Purpose: To evaluate the pharmacist’s assessment of patient eligibility for safe use of isotretinoin and the quality of pharmacist’s counseling.
Patients and Methods: A covert simulated patient (SP) methodology was used in which a trained female researcher, who was 25 years old, played the patient’s role through this cross-sectional study by visiting community pharmacies and requesting isotretinoin capsules through a controlled prescription. A data form was used to collect the information following each pharmacy visit by asking about medical/family history and providing comprehensive counseling about the most common adverse effects, proper use instructions, and the importance of adherence to medication. The pharmacists, who did not initiate counseling, were prompted by the SP.
Results: The pharmacists in 400 pharmacies who agreed to participate were visited by the SP. Only 7 (2%) pharmacists provided a complete assessment of patient eligibility for using isotretinoin with comprehensive counseling. Most of the pharmacists (84%) provided incomplete assessment as indicated by the overall score. Only 11 (3%) pharmacists asked the six crucial questions for the assessment of patient eligibility. On prompting, only 6 (2%) pharmacists provided complete counseling about the expected adverse effects. The most frequently provided adverse effect was dry skin, specifically dry lips (71.8%). A minority of 108 (27%) pharmacists provided education about the importance of using contraception during isotretinoin therapy. A complete level of counseling was provided by 125 (31.3%) pharmacists regarding the lab tests that the SP needs to undergo during therapy. Female pharmacists were more likely to provide counseling about the pregnancy test (mean=134, p=0.001).
Conclusion: Suboptimal level of the patient’s assessment was revealed with poor educational counseling by the community pharmacists. New strategies are needed to improve pharmaceutical care services in the UAE.

Keywords: community pharmacy services, patient simulation, counseling, birth defects

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