Skip to main content
Log in

Management of common ailments requiring referral in the pharmacy: a mystery shopping intervention study

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background Pharmacists can play a key role in managing ailments through their primary roles of supplying over-the-counter (non-prescription) medicines and advice-giving. It must be ensured that pharmacy staff practise in an evidence-based, guideline-compliant manner. To achieve this, mystery shopping can be used as an intervention to assess and train pharmacy staff. Objective To determine if repeated student pharmacist mystery shopping with immediate feedback affected the outcome of scenarios requiring referral to a medical practitioner. To determine what, if any, factors may influence whether referral occurred. Setting Thirteen community pharmacies across metropolitan Sydney, Australia. Methods Sixty-one student pharmacist mystery shoppers visited 13 community pharmacies across metropolitan Sydney once weekly over nine weeks between March–October 2015 to conduct audio-recorded mystery shopping visits with assigned scenarios (asthma, dyspepsia, diarrhoea). Students returned to the pharmacy immediately to provide staff members with feedback. Pharmacy staff were scored by mystery shoppers according to a standardised scoresheet. Score data and other characteristics, such as the assigned scenario, were analysed via correlation and logistic regression modelling. Main outcome measure Whether a student mystery shopper was appropriately referred to a medical practitioner based on the presenting symptoms. Results 158 visits were eligible for analysis. Referral to a medical practitioner was appropriately made in 66% of visits. The regression model provided an R2 value of 0.73; the questioning score of the interaction and if a pharmacist was involved in the interaction were significant predictor of appropriate outcome (p < 0.001 and p < 0.01 respectively). Statistically significant differences were found between median questioning and total scores of interactions involving a pharmacist compared to those that did not (p < 0.001). No statistically significant correlation was found between the number of visits and appropriate outcome (p > 0.05). Conclusions Mystery shopping with feedback did not improve pharmacy staff performance over time. Increased questioning and involvement of a pharmacist in the interaction were significant predictors of referral to a medical practitioner occurring.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Veiga P, Lapão LV, Cavaco AM, Guerreiro MP. Quality supply of nonprescription medicines in Portuguese community pharmacy: an exploratory case study. Res Social Adm Pharm. 2015;11(6):880–90.

    Article  PubMed  Google Scholar 

  2. Smith FJ. Referral of clients by community pharmacists in primary care consultations. Int J Pharm Pract. 1993;2(2):86–9.

    Article  Google Scholar 

  3. Paudyal V, Watson MC, Sach T, Porteous T, Bond CM, Wright DJ, et al. Are pharmacy-based minor ailment schemes a substitute for other service providers? Br J Gen Pract. 2013;63(612):472–81.

    Article  Google Scholar 

  4. Watson MC, Cleland JA, Bond CM. Simulated patient visits with immediate feedback to improve the supply of over-the-counter medicines: a feasibility study. Fam Pract. 2009;26(6):532–42.

    Article  PubMed  Google Scholar 

  5. Bosse N, Machado M, Mistry A. Efficacy of an over-the-counter intervention follow-up program in community pharmacies. J Am Pharm Assoc. 2012;52(4):535–40.

    Article  Google Scholar 

  6. O’Brien MA, Rogers S, Jamtvedt G, Oxman AD, Odgaard-Jensen J, Kristoffersen DT, et al. Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2007;4:CD000409.

    Google Scholar 

  7. Benrimoj SI, Werner JB, Raffaele C, Roberts AS. A system for monitoring quality standards in the provision of non-prescription medicines from Australian community pharmacies. Pharm World Sci. 2008;30(2):147–53.

    Article  PubMed  Google Scholar 

  8. Werner JB, Benrimoj SI. Audio taping simulated patient encounters in community pharmacy to enhance the reliability of assessments. Am J Pharm Educ. 2008;72(6):136.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Xu T, de Almeida Neto AC, Moles RJ. A systematic review of simulated-patient methods used in community pharmacy to assess the provision of non-prescription medicines. Int J Pharm Pract. 2012;20(5):307–19.

    Article  PubMed  Google Scholar 

  10. Berger K, Eickhoff C, Schulz M. Counselling quality in community pharmacies: implementation of the pseudo customer methodology in Germany. J Clin Pharm Ther. 2005;30(1):45–57.

    Article  CAS  PubMed  Google Scholar 

  11. Neto AC, Benrimoj SI, Kavanagh DJ, Boakes RA. Novel educational training program for community pharmacists. Am J Pharm Educ. 2000;64(3):302.

    Google Scholar 

  12. Yu F, de Almeida Neto AC, Moles RJ. Improving children’s cough and cold management in community pharmacies—a simulated caregiver study. Sydney: The University of Sydney; 2014.

    Google Scholar 

  13. Kelly FS, Williams KA, Benrimoj SI. Does advice from pharmacy staff vary according to the nonprescription medicine requested? Ann Pharmacother. 2009;43(11):1877–86.

    Article  PubMed  Google Scholar 

  14. Xu T, de Almeida Neto AC, Moles RJ. Simulated caregivers: their feasibility in educating pharmacy staff to manage children’s ailments. Int J Clin Pharm. 2012;34(4):587–95.

    Article  PubMed  Google Scholar 

  15. Pharmaceutical Society of Australia. Standards for the provision of pharmacy medicines and pharmacist only medicines in community pharmacy. In: Professional practice standards. Canberra: Pharmaceutical Society of Australia; 2006. http://www.psa.org.au/download/standards/s2s3-standards.pdf. Accessed 7 April 2017.

  16. Schneider CR, Everett AW, Geelhoed E, Padgett C, Ripley S, Murray K, et al. Intern pharmacists as change agents to improve the practice of nonprescription medication supply: provision of salbutamol to patients with asthma. Ann Pharmacother. 2010;44(7–8):1319–26.

    Article  PubMed  Google Scholar 

  17. Watson MC. Factors predicting the guideline compliant supply (or non-supply) of non-prescription medicines in the community pharmacy setting. Qual Saf Health Care. 2006;15(1):53–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Watkins K, Wood H, Schneider CR, Clifford R. Effectiveness of implementation strategies for clinical guidelines to community pharmacy: a systematic review. Implement Sci. 2015;10:151.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Benrimoj SI, Werner JB, Raffaele C, Roberts AS. A system for monitoring quality standards in the provision of non-prescription medicines from Australian community pharmacies. Pharm World Sci. 2007;30(2):147–53.

    Article  PubMed  Google Scholar 

  20. de Almeida Neto AC, Benrimoj SI, Gomel M, Fois R. Inappropriate self-medication practices: a pharmacy-based intervention. J Soc Adm Pharm. 1996;13:131–8.

    Google Scholar 

Download references

Acknowledgements

The authors wish to acknowledge all of the Bachelor of Pharmacy students and the pharmacy staff who participated in this study.

Funding

This study was funded by the Australian Government Office for Learning and Teaching (Grant No. SD14-4207); the Pharmacy Council of New South Wales (Grant No. G176927); and Alphapharm Pty Ltd (Grant No. G176862).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jack Charles Collins.

Ethics declarations

The authors have no conflicts of interest to declare.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 291 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Collins, J.C., Schneider, C.R., Faraj, R. et al. Management of common ailments requiring referral in the pharmacy: a mystery shopping intervention study. Int J Clin Pharm 39, 697–703 (2017). https://doi.org/10.1007/s11096-017-0505-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-017-0505-8

Keywords

Navigation