Patient counseling practices in U.S. pharmacies: Effects of having pharmacists hand the medication to the patient and state regulations on pharmacist counseling

Abstract Objectives To determine the amount and type of oral counseling given to shoppers posing as new patients with new prescriptions and to determine how state regulations, pharmacy and pharmacist characteristics, and environmental factors affect oral counseling practices. Design Cross-sectional, observational, correlational study. Setting 41 states and the District of Columbia between January 28 and March 31, 2008. Participants 365 community pharmacy staff members had interactions with shopper-patients. Intervention Shoppers presented new prescriptions in community pharmacies and recorded observations related to oral communication with pharmacy staff. Main outcome measures Oral provision of medication information and risk information to shoppers by pharmacy staff, as well as questions asked of shoppers by pharmacy staff. Results Some form of oral communication related to a medication was reported in 68% of encounters. At least one informational item for either medication was provided for approximately 42% of encounters. At least one risk information item was provided in 22% of encounters. Logistic regression findings indicated that the strongest predictor of oral counseling, either providing information or asking questions, was the pharmacist being the pharmacy staff member who handed the medication to the patient, controlling for all other variables in the models. In addition, having strict state regulations specifying that pharmacists must counsel all patients receiving new prescriptions predicted whether patients received counseling. A more private area for prescription pick up also was a significant predictor. Conclusion The importance of the direct encounter between the pharmacist and patient and strict state regulations mandating that pharmacists counsel patients with new prescriptions were highlighted by these findings.