A review of counseling practices on prescription medicines in community pharmacies

Background: Counseling has become an integral part of community pharmacy practice. Previous reviews of research into pharmacists' counseling practices on prescription medicines have primarily focused on activities at a national level. None have adopted an international perspective. Objectives: To review (1) verbal counseling rates and (2) types of information provided for prescription medicines in community pharmacies and (3) to compare the research methods used in evaluating counseling practice. Methods: Published articles in English (1993-2007) were identified based on searches of on-line databases (international Pharmaceutical Abstracts, PubMed, Medline, EMBASE, CINAHL, and Cochrane Database of Systematic Reviews) and cited references in the articles. Results: Forty research articles met inclusion criteria for studies investigating verbal counseling rates and/or types of information provided for prescription medicines in community pharmacies. The counseling rates reported varied from 8% to 100%, depending oil the research methods used. On average, lower counseling rates were found from consumer and observational studies compared with pharmacist- and simulated-patient studies. The type of prescription also influenced the rate. Higher rates were found in counseling consumers with new compared with regular prescriptions. Information on directions for use, dose, medicine name, and indications was more frequently given than information on side effects, precautions, interactions, contraindications, and storage. Most findings came from self-report and observational methods, each of which has limitations. Few studies used triangulation to overcome methodological limitations. In recent studies, simulated-patient methods have been used increasingly to evaluate counseling practice in the natural environment. Conclusions: The actual counseling rates are difficult to obtain, due to the differences and limitations of each research method. Of all methods, simulated-patient methods appear to be a more reliable method of evaluating counseling practice in pharmacies. In providing information to consumers with prescriptions, pharmacists appear to have fulfilled the minimum legislative requirements or practice standards. (C) 2009 Elsevier Inc. All rights reserved.