Aslanpour, Zohreh; (2001) A study of oral counselling and audit processes for dispensed medications in community pharmacy. Doctoral thesis (Ph.D.), University College London.

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Abstract

The concept of professional audit was introduced to the pharmacy profession by the Royal Pharmaceutical Society in 1992. Since then audit has been promoted as a tool for raising the standard of practice and improving the quality of patient care. The aim of this study was to develop and implement an audit cycle as a tool to explore a community pharmacy service whilst assessing the impact of audit on the service provision and examining its acceptability and feasibility in community settings. The study was based on six stages of an audit cycle. The first stage comprised of semi- structured interviews with community pharmacists, in which provision of oral counselling for dispensed medications was prioritised. This was a service without an universally accepted definition, an issue which was addressed in stage two of the study using a Nominal Group technique. In stage three, the level and content of oral advice given for dispensed medications in community pharmacies were established. It was found that 33% of all the dispensed medications received oral advice in community pharmacies. Standards for the extent of advice for repeat medications as well as items dispensed for the first time were set in stage four which were implemented in the next stage. Feasibility and acceptability of the audit processes and tools devised during the study were examined in a group of self selected pharmacists in stage six of this study. Analysing the findings indicated that the provision of oral advice for dispensed medications was influenced by multitude of variables including the ownership or employment status of pharmacist, number of years of post registration as well as medication status as a repeat or new. The only variable remaining significant in predicting community pharmacists counselling behaviour for different patient groups as well as various therapeutic groups was medication status as repeat or new. Implementation of the audit cycle resulted in pharmacists meeting the agreed standards for provision of counselling demonstrating that audit can be a flexible tool which can accommodate different levels of practice and still achieve an improvement of standards. Implementation of audit continually raises standards of pharmacists' counselling services helping them to meet the public expectations as well as preparing pharmacists to face the challenges involved in embarking on the new roles such as provision of medicine management and the repeat dispensing services as proposed by the Government.

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