An Evaluation of the Quality of Pharmaceutical Care: A Study of the Pharmacist's Compounding Behavior

Abstract

Governmental legislative activity concerning medical care audits has focused the attention of pharmacists on the issue of quality of care being delivered by the pharmacy practitioner. The purpose of this study was to evaluate the pharmacist's services when prescriptions require his compounding skills. A trained shopper presented 50 randomly selected, independent and chain community pharmacists with an authentic prescription requiring compounding. The inscription specified salicylic acid 10 percent in petrolatum. Upon receipt of the finished product the medications were quantitatively and qualitatively analyzed to determine the salicylic acid content. A practitioner-educator panel further evaluated each product for appropriateness in labeling and pharmaceutical elegance. The results of the visits found nine pharmacists who refused to compound the prescription. The probability of securing the medication was greater in nonmass merchandising pharmacies. The assays found one product which contained acetylsalicylic acid instead of the prescribed chemical. Fewer than one-fourth of the remaining products were within a ±5 percent error in the quantity of salicylic acid prescribed. The data were further analyzed to determine relationships between the accuracy with which the medications were prepared and (1) the practice setting patronized, (2) the physical appearance of the products, and (3) the price charged for the medication. No significant differences were found in each analysis. The results suggest that more emphasis should be placed on the importance of compounding accuracy by practitioners.