RESUMO
BACKGROUND: The number of medicines available without a prescription has increased in Brazil as elsewhere. The Brazilian National Health Surveillance Agency recently passed a resolution emphasizing the role of Brazilian pharmacists in promoting rational use of medicines. However, evidence that Brazilian pharmacists monitor the use of non-prescription medicines in the community promoting rational use of medicines is lacking. OBJECTIVE: To assess practice behavior of pharmacists in Brazil when providing nonprescription medicines in the community pharmacy setting. SETTING: The study was conducted in 25 community pharmacies from a city of Aracaju in Brazil. METHODS: Simulated patients visited a convenience sample of 25 pharmacies twice from March to July 2010. During the visits, simulated patients enacted two standardized scenarios: treatment for a persistent headache and childhood diarrhea accompanied by fever. The interactions with the pharmacists were audiovisually recorded using a hidden micro camera. Recordings were later used to fill out a questionnaire designed to evaluate practice behavior of community pharmacists. MAIN OUTCOME MEASURE: The communication and counseling skills of pharmacists in the recommendation of non-prescription medicines, aiming at the rational use of medicines. RESULTS: Pharmacists in the study spent on average 1.5 min counseling the simulated patient. At least one question was asked to assess signs and symptoms in 50.0 % of the simulated patient visits in the headache scenario and in 56.0 % of visits in the childhood diarrhea scenario. Non-pharmacological treatment was suggested in 25 % of visits in the childhood diarrhea scenario. During the counseling process, no pharmacist advised the simulated patient about possible drug interactions, adverse reactions and what to do if the patient forgot to take the medicine. The pharmacists had low scores in measures of non-verbal communication. The sample of this study presented poor communication skills, compromising the treatment of the patients. CONCLUSION: This study showed that the pharmacists' counseling in the simulated patient assessment was insufficient, indicating a need for substantial improvement in practice behavior.
Assuntos
Serviços Comunitários de Farmácia/normas , Medicamentos sem Prescrição/administração & dosagem , Educação de Pacientes como Assunto/normas , Farmacêuticos/normas , Brasil , Competência Clínica , Comunicação , Serviços Comunitários de Farmácia/organização & administração , Estudos Transversais , Feminino , Humanos , Masculino , Educação de Pacientes como Assunto/métodos , Simulação de Paciente , Farmacêuticos/organização & administração , Papel Profissional , Gravação em VídeoRESUMO
A review of the literature relating to the use of virtual patients in teaching pharmaceutical care to pharmacy students was conducted. Only 7 articles met the inclusion criteria for the review and 4 of the studies were conducted in North America. Few articles identified by the review used virtual patient technology that was true-to-life and/or validated.
Assuntos
Simulação por Computador , Instrução por Computador/métodos , Educação em Farmácia/métodos , Humanos , Estudantes de Farmácia , Ensino/métodos , Interface Usuário-ComputadorRESUMO
OBJECTIVE: To review the literature relating to the use of simulated patient methods to enhance communication skills of pharmacists. METHODOLOGY: We searched Embase, Lilacs, Medline, Scielo, and Scopus databases between 1980 and 2008, using "communication skills", "patient counseling" and "pharmacist" as keywords. This search was then further refined by using "simulated patients", "pseudo-customer", "standardized patients", and "mystery shoppers" as additional keywords. RESULTS: The initial search identified 241 published studies. Once further refined, 15 studies met inclusion criteria. CONCLUSION: The majority of studies had an assessment focus aimed at documenting counseling behavior of practicing pharmacists, rather than an educational focus aimed at equipping pharmacists with effective communication skills. In instances where simulated patient methods were used for educational purposes, little regard was given to the role of performance and corrective feedback in shaping communication behavior of pharmacists. The majority of studies failed to describe the competencies and skills being investigated in relation to communication in the practice of pharmacy. PRACTICE IMPLICATIONS: Simulated patient methods provide pharmacy educators with a tool for implementing communication skills in the practice of pharmacy and will serve as a basis for implementing communication skills development programs at the College of Pharmacy of the Federal University of Sergipe in Brazil.