Quality assessment of pharmaceutical care to patients with headaches using the simulated patient method: interaction practice

Relevance. WHO assesses headaches as a global world problem. Russia occupies a leading position in the prevalence of primary headaches. Headaches are one of the most common reasons for visiting a pharmacy for self-medication. The interaction of the pharmacist and the visitor with the headache problem in general determines the quality of pharmaceutical care.

Aim. To assess the practice of the interaction between a patient with a headache and a pharmacist using the simulated patient method.

Materials and methods. Trained simulated patients (women aged 20, 40 and 58 years) visited a total of 101 pharmacies. The dialogue was recorded on a voice recorder, all the features of the interaction were additionally recorded aſter the visit. Special forms were filled out based on the information received. The data was processed using Microsoſt Excel 2010 and STATISTIKA 10.0.

Results. The average interaction time was 98.2±3.8 seconds. There was a high frequency of spontaneous recommendations without preliminary questions (66.3%), a small number of questions asked (0.84±0.1). These indicators practically did not depend on various factors (type of pharmacy organization, age of the pharmacist, age of the simulated patient, the presence of a queue, and others).

Conclusion. The results of the study demonstrate a low level of interaction between pharmacists and visitors with a headache, as well as a practical absence of involvement in the process of providing pharmaceutical care, which negatively affects its quality: frequent spontaneous recommendations, short consultations and rare questions. The approach to the interaction of pharmacists with visitors with headaches is formal and requires standardization.

1. Dryomova NB, Korzhavyh EA, Litvinova TM. Pharmaceutical care: term and concept. Farmaciya. 2005;(2):37–45. (In Russ.).

2. Allemann SS, van Mil JW, Botermann L, et al. Pharmaceutical care: the PCNE definition 2013. Int. J. Clin. Pharm. 2014 Jun;36(3):544–55. doi: 10.1007/s11096-014-9933-x

3. Ayzenberg I, Katsarava Z, Mathalikov R, et al. The burden of headache in Russia: validation of the diagnostic questionnaire in a population-based sample. Eur. J. Neurol. 2011 Mar;18(3):454–9. doi: 10.1111/j.1468-1331.2010.03177.x

4. Ayzenberg I, Katsarava Z, Sborowski A, et al. Headache-attributed burden and its impact on productivity and quality of life in Russia: structured health-care for headache is urgently needed. Eur. J. Neurol. 2014 May;21(5):758–65. doi: 10.1111/ene.12380

5. Lebedeva ER, Kobzeva NR, Tsypushkina TS et al. Prevalence of headache disorders diagnosed according ICHD-3betta in three different social settings. Eur. J. Neurol. 2014;36(6):113–4. doi: 10.1177/0333102415596442

6. Lebedeva ER, Kobzeva NR, Gilev D, Olesen J. Prevalence of primary headache disorders diagnosed according to ICHD-3 beta in three different social groups. Cephalalgia. 2016 May;36(6):579–88. doi: 10.1177/0333102415596442

7. Mamo S, Ayele Y, Dechasa M. Self-Medication Practices among Community of Harar City and Its Surroundings, Eastern Ethiopia. J. Pharm. (Cairo). 2018 Jul 25;2018:2757108. doi: 10.1155/2018/2757108

8. Gavazova EZ, Grekova-Kafalova DD. Pharmaceutical care for patients with headache. Folia Med. (Plovdiv). 2022 Jun 30;64(3):373–9. doi: 10.3897/folmed.64.e63095

9. Naito Y, Ishii M, Kawana K, Sakairi Y, Shimizu S, Kiuchi Y. [Role of pharmacists in a community pharmacy for self-medication of patients with headache]. Yakugaku Zasshi. 2009 Jun;129(6):735–40. Japanese. doi: 10.1248/yakushi.129.735

10. Steiner TJ, Jensen R, Katsarava Z, et al. Aids to management of headache disorders in primary care (2nd edition): on behalf of the European Headache Federation and Liſting The Burden: the Global Campaign against Headache. J. Headache Pain. 2019 May 21;20(1):57. doi: 10.1186/s10194-018-0899-2

11. who.int Vsemirnaya Organizaciya Zdravoohraneniya. Informacionnyj byulleten’ Vsemirnoj Organizacii Zdravoohraneniya "Golovnye boli", 2016. (In Russ.)]. Доступ по: https://www.who.int/ru/news-room/fact-sheets/detail/headache-disorders. Ссылка активна на 14.02.2023.

12. Reshetko OV, Grishin AI. Pharmaceutical care for patients with headache: a systematic review of clinical studies. Clin. Pharmacol. Ther. 2022;31(3):47–52. (In Russ.)]. doi: 10.32756/0869-5490-2022-3-47-52

13. Björnsdottir I, Granas AG, Bradley A, Norris P. A systematic review of theuse of simulated patient methodology in pharmacy practice research from 2006 to 2016. Int. J. Pharm. Pract. 2020 Feb;28(1):13–25. doi: 10.1111/ijpp.12570

14. Hammad EA, Elayeh E, Tubeileh R, Watson M, Wazaify M. A simulated patient study assessing over the counter supply and counseling in Jordan: responding to headache complaints. Int. J. Clin. Pharm. 2018 Oct;40(5):982–6. doi: 10.1007/s11096-018-0679-8

15. Kuzina NV. Value and price: economic and ethical aspects of modern pharmaceutical business (retail segment). Krasnoyarsk Science. 2016;2(25):202–25. (In Russ.)]. doi: 10.12731/2070-7568-2016-2-202-225

16. Maier JA, Pickering G, Giacomoni E, Cazzaniga A, Pellegrino P. Headaches and Magnesium: Mechanisms, Bioavailability, Therapeutic Efficacy and Potential Advantage of Magnesium Pidolate. Nutrients. 2020 Aug 31;12(9):2660. doi: 10.3390/nu12092660

17. Barmherzig R, Rajapakse T. Nutraceuticals and Behavioral Therapy for Headache. Curr. Neurol. Neurosci. Rep. 2021 May 10;21(7):33. doi: 10.1007/s11910-021-01120-3