title: Australian pharmacies prevent potential adverse reactions in patients taking warfarin requesting over-the-counter analgesia.
abstract: OBJECTIVE
  The objective of this article was to assess if Australian pharmacy staff prevent potential adverse reactions in warfarin patients requesting over-the-counter (OTC) analgesia.
  
  
  METHODS
  Mystery shoppers entered 170 pharmacies across Australia to request OTC analgesia for a hypothetical patient with a wrist injury who currently takes warfarin following a heart valve replacement. The request was made to the first pharmacist or non-pharmacist staff member to approach the mystery shopper. The interaction was audio-taped and assessed by a pharmacist. The OTC analgesic recommended was assessed for the potential to cause an adverse bleeding event. The quality of advice given with the OTC analgesic was assessed against determined criteria. Results were compared with scenarios of similar request type where the hypothetical patient was not taking warfarin.
  
  
  RESULTS
  Mystery shoppers enquiring about taking OTC analgesics concomitantly with warfarin had access to the pharmacist in 97.0% of cases. All 170 pharmacies recommended OTC analgesics that were less likely to cause adverse events when taken with warfarin. The advice given and the communication between pharmacy staff and mystery shoppers were of high quality.
  
  
  CONCLUSIONS
  Australian pharmacies support the quality use of medicines by patients taking warfarin by providing expeditious access to the pharmacist, appropriate recommendations of OTC analgesics, high standards of quality of advice and they communicate in a way to ensure ease of understanding by the consumer. The protocols used by pharmacy staff help prevent potentially serious adverse drug events.
authors.affiliation: The Australian College of Pharmacy, Canberra, ACT, Australia.
authors.forename: Brett V
authors.initials: BV
authors.lastname: MacFarlane
authors.forename: Jenny K
authors.initials: JK
authors.lastname: Bergin
authors.forename: Peter
authors.initials: P
authors.lastname: Reeves
authors.forename: Andrew
authors.initials: A
authors.lastname: Matthews
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D000925:Anticoagulants / Q000009:adverse effects*; D001315:Australia; D003157:Community Pharmacy Services; D006801:Humans; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D010594:Pharmacies; D010595:Pharmacists; D014859:Warfarin / Q000009:adverse effects*
chemical_list: D000700:Analgesics; D000925:Anticoagulants; D004366:Nonprescription Drugs; D014859:Warfarin
keywords: NSAID; analgesics; pharmacist; pharmacy; warfarin