Management of minor ailments in a community pharmacy setting: Findings from simulated visits and qualitative study in Gondar town, Ethiopia

<div><p>Community pharmacy professionals are being widely accepted as sources of treatment and advice for managing minor ailments, largely owing to their location at the heart of the community. The aim of the present study was, therefore, to document the involvement of community pharmacy professionals in the management of minor ailments and perceived barriers that limit their provision of such services. Simulated patient (SP) visits combined with a qualitative study using in-depth interviews was conducted among community pharmacy professionals in Gondar town, Northwest Ethiopia. Scenarios of three different minor ailments (uncomplicated upper respiratory tract infection, back pain and acute diarrhea) were selected and results were reported as percentages. Pharmacy professionals were also interviewed about the barriers in the management of minor ailments. Out of 66 simulated visits, 61 cases (92.4%) provided one or more medications to the SPs. Pharmacy professionals in 16 visits asked SPs information on details of symptoms and past medical and medication history. Ibuprofen alone or in combination with paracetamol was the most commonly dispensed analgesics for back pain. Oral rehydration fluid (ORS) with zinc was the most frequently dispensed medication (33.3%) for the management of acute diarrhea followed by mebendazole (23.9%). Moreover, amoxicillin-clavulanic acid capsule (35%) followed by Amoxicillin (25%) were the most commonly dispensed antibiotics for uncomplicated upper respiratory tract infection. Lack of clinical training and poor community awareness towards the role of community pharmacists in the management of minor ailments were the main barriers for the provision of minor ailment management by community pharmacy professionals. Overall, community pharmacists provided inadequate therapy for the simulated minor ailments. Lack of access to clinical training and poor community awareness were the most commonly cited barriers for providing such services. So as to improve community pharmacists’ involvement in managing minor ailments and optimize the contribution of pharmacists, interventions should focus on overcoming the identified barriers.</p></div

The scenarios employed in the simulated study, Gondar, 2016.

<p>The scenarios employed in the simulated study, Gondar, 2016.</p

Medications dispensed in response to the simulated scenario, Gondar town, Ethiopia, 2016.

<p>Medications dispensed in response to the simulated scenario, Gondar town, Ethiopia, 2016.</p

Actions and advice in response to the simulated scenario, Gondar town, Ethiopia, 2016.

<p>Actions and advice in response to the simulated scenario, Gondar town, Ethiopia, 2016.</p

Value assessment of deprescribing interventions: suggestions for improvement

Polypharmacy and the inappropriate use of medications is a prevalent, potentially harmful, and costly problem that can be addressed by deprescribing, which is defined as the “systematic process of identifying and discontinuing drugs when existing or potential harms outweigh existing or potential benefits within the context of an individual patient's care goals, functional status, life expectancy, values, and preferences.”1 Evidence from clinical trials has demonstrated that deprescribing interventions can reduce the number of potentially inappropriate medications; yet the next question of whether such interventions are cost-effective is often unanswered.2 In this commentary, we describe current practices in assessing the value of deprescribing interventions and their limitations, and then suggest potential improvements. </p

Fisher exact test to explore potential predictors of competency of adequate inhalational technique, 2017.

<p>Fisher exact test to explore potential predictors of competency of adequate inhalational technique, 2017.</p

Overall score of the respondents on MDI technique, Gondar, 2017.

<p>Overall score of the respondents on MDI technique, Gondar, 2017.</p

Socio-demographic characteristics of the respondents, Gondar, 2017 (N = 62).

<p>Socio-demographic characteristics of the respondents, Gondar, 2017 (N = 62).</p

Frequency of evaluation of respondents to demonstrate each step of metered dose inhaler technique, 2017.

<p>Frequency of evaluation of respondents to demonstrate each step of metered dose inhaler technique, 2017.</p