title: [Using the simulated patient methodology to assess counselling for acute diarrhoea - evidence from Germany].
abstract: OBJECTIVE
  First, to assess the quality of counselling for acute diarrhoea; second, to evaluate the patient's approach and different user groups as a determinant of counselling.
  
  
  METHODS
  The simulated patient methodology was used in all 21 community pharmacies in a north-eastern German city with a population of about 63,000. Four scenarios related to self-medication for acute diarrhoea were developed and used in all pharmacies (total: 84 visits). Two scenarios were direct product-based requests for loperamide (scenario 1: a 74-year old woman with diabetes and hypertension; scenario 3: a 30-year old man with no primary disease). Scenario 2 and 4 were symptom-based requests asking for medicine for acute diarrhoea (scenario 2: a 74-year old woman with diabetes and hypertension; scenario 4: a 30-year old man with no primary disease). The assessment sheet included 9 objective items relating to the pharmacological advice to avoid a subjective evaluation by the mystery shoppers (e. g., the friendliness of the customer contact). Simulated patient visits were conducted covertly by five untrained female master students. After evaluation of the data every pharmacy received an individual performance feedback to encourage behavioural change and improve counselling quality.
  
  
  RESULTS
  Overall, the quality of counselling was quite poor (277 out of 756 possible points). The most commonly provided information was dosage (86.9 %); information on adverse effects was least commonly provided (3.6 %). Furthermore, there was a huge difference in the counselling quality between the pharmacies (minimum 4 points, maximum 20 points out of 36 possible points). The symptom-based requests scored significantly better (95 and 85 out of 189 possible points) than the direct product-based requests (42 and 55 out of 189 possible points). The symptom-based requests had a significantly better counselling quality for an older woman with primary disease than for a younger man without any primary disease. This difference was not observed with the direct product-based requests.
authors.affiliation: Hochschule Neubrandenburg, Fachbereich Gesundheit, Pflege, Management, Neubrandenburg, Deutschland. Electronic address: langer@hs-nb.de.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Langer
authors.affiliation: Hochschule Neubrandenburg, Fachbereich Gesundheit, Pflege, Management, Neubrandenburg, Deutschland.
authors.forename: Elisa
authors.initials: E
authors.lastname: Bull
authors.affiliation: Hochschule Neubrandenburg, Fachbereich Gesundheit, Pflege, Management, Neubrandenburg, Deutschland.
authors.forename: Tina
authors.initials: T
authors.lastname: Burgsthaler
authors.affiliation: Hochschule Neubrandenburg, Fachbereich Gesundheit, Pflege, Management, Neubrandenburg, Deutschland.
authors.forename: Julia
authors.initials: J
authors.lastname: Glawe
authors.affiliation: Hochschule Neubrandenburg, Fachbereich Gesundheit, Pflege, Management, Neubrandenburg, Deutschland.
authors.forename: Monique
authors.initials: M
authors.lastname: Schwobeda
authors.affiliation: Hochschule Neubrandenburg, Fachbereich Gesundheit, Pflege, Management, Neubrandenburg, Deutschland.
authors.forename: Karen
authors.initials: K
authors.lastname: Simon
mesh_terms: D003376:Counseling / Q000379:methods* / Q000592:standards; D003967:Diarrhea / Q000523:psychology; D005260:Female; D005858:Germany; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010594:Pharmacies
keywords: Akuter Durchfall; Apotheken; Beratungsqualität; Nicht-verschreibungspflichtige Arzneimittel; Non-prescription medication; Testkauf; acute diarrhoea; mystery shopping; pharmacies; quality of counselling; simulated patient methodology; „Simulated Patient“-Methode