Objective
The primary objective of the study was to assess the quality of self-care counselling from pharmacy practitioners, supported
by national clinical guidelines. The research questions addressed (1) the distribution of symptoms among customers in need
of self-care counselling, (2) the quality of the self-care advice provided by pharmacy practitioners, (3) the degree of customer
compliance with appropriate pharmacy advice versus the extent of symptom relief, (4) and versus a subsequent medical care
visit, and (5) which resource the customers would have turned to in the first place for their ailments, had the pharmacy practitioner
not been available.
Setting
Three large community pharmacies with non-prescription self-selection departments in central Sweden.
Methods
Ten pharmacy practitioners counselled all customers ≥18 years old, with whom a dialogue was initiated on advice or products
for self-care. The counselling was based on national clinical guidelines for self-care advice in the form of a software decision
support program. The data collection consisted of documentation of background customer information, independent assessments
of the quality of the advice provided and of telephone follow-ups.
Results
Of all documented symptoms (n = 250), the most common were allergy (26.4%), musculoskeletal symptoms (8.4%) and dyspepsia (7.2%). Independent assessments
of the documentation by a physician and a pharmacist found that self-care advice was appropriate to give 97.6% of the customers
and that the advice provided was correct in 88.4% of the cases. In total, 217 cases (86.8%) were fully approved by both the
physician and the pharmacist. Among the 182 customers who claimed that they complied completely with appropriate advice provided,
135 (74.2%) experienced a great improvement in symptoms. Among the 21 who had only partly followed the advice, six (28.6%)
reported the same level of improvement (p < 0.001). If the pharmacy practitioner had not been available, 56.8% of the customers would have turned to medical care in
the first instance.
Conclusions
The study demonstrates the high quality of pharmacy practitioners’ self-care counselling supported by IT-based national clinical
guidelines, including a favourable impact on customers’ ailments. Furthermore, it reveals that pharmacy practitioners greatly
relieve the pressure on the health-care system, resulting in reduced costs to society.
Keywords Clinical guidelines - Counselling - Non-prescription drugs - Outcomes - Pharmacy practitioner - Quality - Self-care - Sweden