COMMUNITY PHARMACISTS ASSESSMENTS AND RECOMMENDATIONS FOR TREATMENT IN 4 CASE SCENARIOS

OBJECTIVE: TO evaluate community pharmacists' interpersonal skills, ab ility to make appropriate assessment of a patient's drug-related probl ems, and ability to propose an appropriate therapeutic plan. DESIGN: A disguised shopper design was used. Four different case scenarios were designed, with input from a five-member community/primary care pharma cist advisory committee. Two different cases were assigned to each of two shoppers. One hundred and one pharmacies were shopped twice, total ing 202 shopping experiences. A three-member evaluation committee made up of clinical faculty members in ambulatory care and internal medici ne assessed the appropriateness of the recommendations. SETTING: The s tudy was conducted in 101 randomly selected community pharmacies in th e Pittsburgh area, including both chain and independent pharmacies. MA IN OUTCOME MEASURES: Main outcome measures included the quality of the pharmacists' interpersonal skills, patient assessment skills, and rec ommendations. RESULTS: The majority of pharmacists demonstrated accept able to good interpersonal skills. Overall, 31.7% of the recommendatio ns were appropriate, while 39.1% were poor (i.e., recommendations that would likely worsen the patient's condition or potentially harm the p atient). In 33.2% of the cases, recommendations were made without prio r assessment of the patient's problems. CONCLUSIONS: A lack of clinica l knowledge and skills should be considered as a barrier that must be overcome if the provision of pharmaceutical care is to become a realit y in community practice.