Community pharmacists’ response to complaints of gastroesophageal reflux: A simulated patient study in the Northern United Arab Emirates

by Fatima Boura, Moawia M. Al-Tabakha, Nageeb Hassan, Mohamad Darwich

Introduction

Patients frequently use gastric acid-reducing agents (ARAs) to treat symptoms affecting the gastrointestinal tract. Thus, the risk for drug–drug interactions (DDI) is a serious concern. This potentially makes the community pharmacist (CP) act as a primary intervention by providing the appropriate counseling and dispensing practice.

Objective

To evaluate CPs’ counseling and dispensing practices regarding complaints of Gastroesophageal Reflux Disease (GERD), including recommending an appropriate course of action to prevent possible DDIs.

Materials and methods

A simulated patient (SP) methodology was used in this study. The community pharmacies in Ajman and Sharjah were visited by SP who’s responsible for acting as a patient, and by an observer who’s responsible for focusing on the interaction between the SP and the CPs without engagement. Data were recorded using a preprepared data collection form. Performance feedback was sent to the CPs after concluding all visits. Counseling and dispensing scores were classified based on the total scores to poor, inadequate, and complete. Appropriateness of the pharmacist’s decision was defined as dispensing antacid and advising of separating doses apart in time.

Results

A total of 150 community pharmacies was included in the data analysis. The findings of the current study demonstrated poor counseling and dispensing for the vast majority of the participants (81.3% and 67.3% of respondents, respectively). Only 4% of the CPs advised the SP to have a time interval between antacid and cefuroxime axetil. A significant difference in counseling scores was found between pharmacies located in Ajman and Sharjah (p = 0.01). Also, there was a significant difference in dispensing scores between independent and chain pharmacies (p = 0.003).

Conclusions

The findings revealed inadequate counseling and dispensing practice by CPs. This study highlighted the need for continuous professional training programs to endow the CPs with the knowledge necessary for improving the CPs’ counseling and dispensing practices.