title: The power of the patient question: A secret shopper study.
abstract: To examine the effect of one standardized patient question on the length, number and type of new topics pharmacists addressed. To explore how community pharmacists counsel secret shoppers on two types of over-the-counter (OTC) medications-ibuprofen (IB) and emergency contraceptives (EC).
  
  
  
  25 pharmacists from 7 independent, midwestern community pharmacies consented to have secret shoppers purchase an OTC medication and to have their consultations audio-recorded. Following standardized scenarios, 5 secret shoppers audio-recorded 73 encounters. At the end of 36 encounters secret shoppers asked one standard question, "What else should I know before taking this product?" Role Theory informed the study design with apriori hypotheses that topics assessed, topics discussed, and consultation length would vary by the OTC medication (IB or EC) and whether secret shoppers asked a question. Audio-recording coding had high inter-rater reliability (kappa=0.94).
  
  
  
  Length of encounter was significantly associated with patients asking the question (p<0.05), but not type of OTC medication. On average 1.22 new topics were discussed with a patient question. New topics included information about safe and efficacious use of the OTC's.
  
  
  
  Results highlight the importance of encouraging patients to ask pharmacists their questions about OTC products for safe use and thorough consultations.
authors.affiliation: Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin, Madison, WI, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Peters
authors.affiliation: Center of Surgical Health Services Research, Department of Surgery, School of Medicine, Stanford University, CA, USA.
authors.forename: Karishma
authors.initials: K
authors.lastname: Desai
authors.affiliation: Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin, Madison, WI, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ricci
authors.affiliation: Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin, Madison, WI, USA.
authors.forename: Dan
authors.initials: D
authors.lastname: Chen
authors.affiliation: Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin, Madison, WI, USA.
authors.forename: Monny
authors.initials: M
authors.lastname: Singh
authors.affiliation: Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin, Madison, WI, USA. Electronic address: jmpeters@wisc.edu.
authors.forename: Betty
authors.initials: B
authors.lastname: Chewning
mesh_terms: D003157:Community Pharmacy Services; D003281:Contraceptives, Postcoital / Q000627:therapeutic use; D037001:Directive Counseling; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs; D010353:Patient Education as Topic; D010594:Pharmacies / Q000706:statistics & numerical data; D010595:Pharmacists; D011369:Professional-Patient Relations; D013637:Tape Recording
chemical_list: D003281:Contraceptives, Postcoital; D004366:Nonprescription Drugs; D007052:Ibuprofen
keywords: Counseling; Emergency contraceptive; Medications; Over-the-counter (OTC); Patient activation; Pharmacist; Role theory