Management of over-the-counter insomnia complaints in Australian community pharmacies: a standardized patient study.
OBJECTIVE
To evaluate the current management of over-the-counter (OTC) insomnia complaints in Australian community pharmacies using standardized patient methodology.


METHODS
Trained standardized patients visited a sample of 100 randomly selected South East Queensland community pharmacies in June 2011. The standardized patients enacted two OTC insomnia scenarios: a direct product request (DPR) (n = 50) and a symptom-based request (SBR) (n = 50). Results of the interactions were documented immediately after each visit and evaluated using the Pharmaceutical Society of Australia's WHAT STOP GO protocol as a standard comparison.


RESULTS
Of all DPRs, 30% were handled entirely by the pharmacist, 70% of staff enquired about specific symptoms and 28% investigated the cause of insomnia. No staff investigated the frequency of product use. The DPR scenario resulted in a 92% supply of the requested doxylamine product (Restavit). In the SBR scenario, 18% of requests were handled entirely by the pharmacist, 58% of staff enquired about specific symptoms and 44% investigated the cause of insomnia. Staff recommended medicated products (38%), or herbal (78%) or non-drug techniques (18%). Investigation into smoking and alcohol intake was not undertaken in DPR or SBR interactions, while questioning on caffeine intake was undertaken in 2 and 14% of cases respectively. There were no significant differences found in the handling of sleep requests by pharmacists compared to pharmacy assistants.


CONCLUSIONS
The standardized patient methodology was a successful way to assess the community pharmacy counselling provided with OTC sleep requests and suboptimal staff responses were found when compared with recommended practice standards.
School of Pharmacy, University of Queensland, Brisbane, Queensland, Australia.
Krishneeta C
KC
Kashyap
Lisa M
LM
Nissen
Simon S
SS
Smith
Greg
G
Kyle
D000328:Adult; D000368:Aged; D001315:Australia; D003157:Community Pharmacy Services / Q000458:organization & administration*; D003625:Data Collection; D004319:Doxylamine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006920:Hygiene; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008019:Life Style; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010595:Pharmacists; D028321:Plant Preparations; D011368:Professional-Family Relations; D011793:Queensland; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D055815:Young Adult
D006993:Hypnotics and Sedatives; D004366:Nonprescription Drugs; D028321:Plant Preparations; D004319:Doxylamine
clinical pharmacy; clinical practice; community pharmacy; non-prescription medicines