Factors predicting poor counselling about prescription medicines in Swedish community pharmacies

Objective: To investigate predictors of 'no counselling', 'no questioning' and 'provision of no information' for three prescribed medicines in community pharmacies in Sweden. Methods: One hundred pharmacies were randomly selected, stratified by size and location. Three simulated patients visited each with a prescription for fluoxetine, naproxen or metformin. Counselling details and information about the pharmacy and its staff were recorded immediately after the visit. Data were weighted by strata size for analysis. Results: Data were available for 292 prescriptions. No questioning occurred for 108 (37%), no information for 75 (26%) and no counselling (no questioning and no information) occurred with 53 (18%) prescriptions. Staff ignored negative responses about previous usage and rarely asked further questions or provided information. Predictors of no counselling included when the staff member was over 50 years old (OR = 2.10, CI = 1.18-3.43), during lunchtime (OR = 1.69, CI = 1.00-2.86) and when the prescription was for metformin (OR = 2.49, CI = 1.34-4.63). Conclusion: The findings suggest the importance of therapeutic class and busy times as predictors of no counselling about prescription medicines in Swedish pharmacies. Practice Implications: Although pharmacy staff should counsel patients, in many cases they did not. Why this happens and what hinders them from doing so needs to be further investigated. © 2010 Elsevier Ireland Ltd.