The practice of OTC counseling by community pharmacists in Parana, Brazil

Halila GC, Junior EH, Otuki MF, Correr CJ. The practice of OTC counseling by community pharmacists in Parana, Brazil. Pharmacy Practice 2015 Oct-Dec;13(4):597. doi: 10.18549/PharmPract.2015.04.597 Original Research The practice of OTC counseling by community pharmacists in Parana, Brazil Gerusa C. HALILA, Edson H. JUNIOR, Michel F. OTUKI, Cassyano J. CORRER. Received (first version): 6-Apr-2015 Accepted: 13-Oct-2015 * ABSTRACT Background: In order to provide appropriate advice to the patient at the time of dispensing and over-the-counter (OTC) medication counseling, community pharmacists need access to current and reliable information about medicines. Brazilian pharmacists have assumed new functions such as prescribing medication, in a dependent model, based in protocols. Objective: To examine the practice of community pharmacists in a Brazilian State, focusing on OTC recommendation. Method: A cross-sectional survey of community pharmacists in a state of Brazil was conducted from October 2013 to January 2014, with data collection through a pre-piloted self-administered anonymous survey via Survey Monkey® platform. Following ethical approval, the online instrument was sent to 8,885 pharmacists registered in Parana State, Brazil, focusing on professionals working in community pharmacies. The questionnaire assessed the community pharmacy setting, the search for information, the knowledge of the evidencebased practice, the important factors to consider when recommending an OTC medicine, and the pharmacist prescribing. Responses were imported into SPSS® (version 22.0) for analysis. Nonparametric tests were used to assess the association between responses and demographic information with a significance level less than 5% (p<0.05). Results: Of the pharmacists, 97.4% dispensed medications and counseled patients for a median of six hours per day. Product's efficacy (97%) and adverse effects (62.3%) were the most important factors taken into account when counseling a nonprescription medicine. Few pharmacists knew the meaning of terms related to evidence-based health. Most respondents agreed that pharmacists have the necessary training to prescribe. Conclusion: Over-the-counter medication counseling is a daily practice among Brazilian pharmacists. Learning needs exist for community pharmacists in relation to evidence-based practice. Thus, sources of information with good evidence could be used daily by community pharmacists, especially as regards nonprescription medication counseling. Keywords: Nonprescription Drugs; Professional Practice; Pharmacies; Evidence-Based Practice; Brazil * Gerusa Clazer HALILA. MSc. Pharmacy Department, Federal University of Parana, Curitiba; & Pharmaceutical Sciences Department, State University of Ponta Grossa, Ponta Grossa, PR (Brazil). Edson Hipólito JUNIOR. MSc. Pharmacy Department, Federal University of Parana, Curitiba, PR (Brazil). Michel Fleith OTUKI. PhD. Pharmacy Department, Federal University of Parana, Curitiba; & Pharmaceutical Sciences Department, State University of Ponta Grossa, Ponta Grossa, PR (Brazil). Cassyano Januário CORRER. PhD. Pharmacy Department, Federal University of Parana, Curitiba, PR (Brazil). INTRODUCTION Pharmacists in community pharmacies are placed in a position of trust, especially in how they relate directly to patients and are readily available to 1 provide advice and information. In Brazil, according to the National Health Surveillance Agency (ANVISA), a regulatory agency similar to the Food and Drugs Administration (FDA) in the United States of America, community pharmacists can dispense medicines with the presentation of a prescription and they can recommend 2,3 nonprescription medicines for patients' symptoms. In this context, pharmacists should educate and counsel patients about nonprescription medicines and provide pharmaceutical services, established by ANVISA2, such as determining blood pressure, administration of injectable drugs, and verification of blood glucose. Community pharmacies in Brazil are not required by law to be owned by pharmacists. However, pharmacists are required to be present in pharmacies during opening hours, and all must be registered with the Regional Pharmacy Council of the State where they live. The working hours of community pharmacists is 44 hours per week. In pharmacy setting there is no requirement for a space to meet seated patients, although this is important for more quality in dispensing process. The existence of computers with access to the internet, although not mandatory, it is important to carry out research and consultations on medicines. According to the World Health Organization (WHO), nonprescription medicines are drugs approved by health authorities to treat minor ailments and symptoms. Internationally known as over-thecounter (OTC), they are available without prescription because of their safety and effectiveness, if used in accordance with the guidelines available on the package inserts and on labels.4 However, these medications are not without risk. Therefore, it is important the pharmacist counseling at the time of purchase to promote the safe use of these medicines. In Brazil, most pharmacies stores OTC medicines behind the counter, although ANVISA allow them to be on the shelves within reach of customers. Thus, to be purchased is necessary to have the pharmacist's advice. Therefore, in order for the pharmacist to provide appropriate counseling to the patient at the time of dispensing medication and OTC in the best way, he needs access to current and reliable information about medicines. Access to sources of information about medicines and participation in continuing education are essential in this context. Thus, the www.pharmacypractice.org (ISSN: 1886-3655) 1 Halila GC, Junior EH, Otuki MF, Correr CJ. The practice of OTC counseling by community pharmacists in Parana, Brazil. Pharmacy Practice 2015 Oct-Dec;13(4):597. doi: 10.18549/PharmPract.2015.04.597 main objective of continuing professional development is to improve the quality of services provided by community pharmacists.1 Thereby, it is important for pharmacists in the OTC counseling not only consider their own experiences, but also the scientific information arising from the ability to analyze scientific data published, as recommended by evidence-based practice (EBP). In this context, we highlight the published clinical trials evaluating the efficacy and safety of medicines. Currently, in Brazil as in other countries, community pharmacists have assumed new functions such as prescribing medications, a practice seen as a way to reduce the costs of healthcare, improve patients' access to this5, decrease the number of non-urgent 6 visits to the emergency services , and further emphasize the importance of the pharmacist to society. However, among countries, there are differences in 7 pharmacist prescribing model , as well as the interpretation of the term. The model adopted in Brazil is (...truncated)