Client and pharmacist factors affecting practice in the management of upper respiratory tract infection presented in community pharmacies: a simulated client study

Abstract

Abstract Objectives To assess the quality of care provided by community pharmacists for simulated clients (SCs) with upper respiratory tract infection (URI) and to examine the effects of gender and appearance of socioeconomic status (SES) of the SCs on the practice. Setting Thirty-two community pharmacies in the south of Thailand with four male and four female SCs. Method Each SC visited eight community pharmacies twice, 1month apart, once with moderate and once with an appearance of low SES, in random order. Key outcome variables were history-taking, advice-giving, and antibiotic-dispensing, based on international guidelines. Descriptive statistics and mixed-effects models with nesting of SCs and community pharmacies were conducted. Key findings The mean scores for history-taking and advice-giving were low. The proportions of 128 encounters ending up with antibiotics, corticosteroids and nonsteroidal anti-inflammatory drugs were 87.5, 12.5 and 7.8%, respectively. Pharmacist practice did not differ by SC gender or appearance of SES. Conclusion Such practice by pharmacists needs improvement. Further studies to confirm the lack of effect of clients' gender and SES are needed.