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Check See the answer Next Next quiz Review. Here are some hints to get you started in German! Read more. The Paul Noble Method: no books, no rote memorization, no chance of failure. The assessment form, completed immediately postvisit by the simulated patient, included 9 objective items scored using dichotomous scales to produce a scale from 0 to 9.
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After evaluating the data, every pharmacy received individual performance feedback to encourage behavioural changes and improve the quality of the counselling provided. Overall, the quality of counselling was poor mean score of 3. This study highlighted the current deficits in appropriate counselling provided by community pharmacies in Germany. Worldwide, the number of medicinal products that can be obtained over the counter, that is, purchased in pharmacies without a medical prescription, is growing.
Pharmacies can help to prevent risks resulting from improper use or at least significantly reduce these risks, because employees in the pharmacies should have extensive knowledge about the medications in terms of their effects, side effects and use. Good advice is not only helpful for the customer or patient, but also plays a crucial role in competition between pharmacies.
A good advisory service in this context is an important means of gaining a competitive edge. Various studies available for Germany show that the quality of the advice provided to customers by pharmacies has considerable room for improvement. Acute diarrhoea is also quite an important indication because it is one of the most common medical conditions in Germany. It is therefore also necessary to query how the symptoms have progressed to take into account the duration, concomitant symptoms and the severity and, where necessary, to recommend the patient seek medical advice.
The primary aim of this study was to investigate the counselling practices of community pharmacies provided for acute diarrhoea using simulated patients. The secondary objective was to evaluate the role of the patient's approach and different user groups in determining the outcome of counselling. This approach was used to assess the quality of services provided and is a type of participatory observation. The test buyers simulated an apparently real situation to participate in a service provision process.
This was subsequently evaluated by the test buyers to reveal any possible deficiencies. The selection process was based on their participation in a student research project in their first year of graduate studies in Health Sciences. When carrying out the individual test purchases, there was no differentiation made regarding the education of the pharmacy personnel providing the advice. According to work regulations for pharmacies, pharmacies in Germany are obliged to implement a quality management system that is intended to ensure a comprehensive advisory service.
The assessment form only included 9 objective items that refer to the pharmacological advisory service in order to avoid a subjective evaluation and thus any latitude in the assessments made by the test buyers such as the friendliness of the customer contact. Weighting of the individual items was omitted because this in turn would depend on subjective considerations.
To avoid influencing the quality of the advisory service provided by the pharmacies being tested and thus possibly a situation that no longer reflects reality Hawthorne effect , the test purchases were covert; that is, they were conducted without informing the particular pharmacy beforehand, using a similar approach to some other international studies. For this reason, two of the scenarios were designed as medication based test scenarios 1 and 3 and the other two were symptom based test scenarios 2 and 4. We also intended to test whether the quality of the advisory service provided by pharmacies differed depending on whether the preparation requested was for an older person with underlying diseases or for a younger person with no underlying diseases.
The grandmother's fluid intake is adequate, no vomiting, no blood in the stool, no fever. There was 1 week between each of the individual scenarios with 21 test purchases each. The pharmacies to be tested were allocated randomly to the particular test buyers in the first step.
As a result, each test buyer was allocated a total of 16—18 test purchases across all the scenarios. After the allocation but before the visits, we subsequently checked and ensured that none of the pharmacies were visited multiple times by any one test buyer to prevent the risk of the test buyers being exposed. This produced an overview of which test buyers visited which pharmacy using which scenario at what time.
Before data collection was started, each test buyer carried out four pretests outside Neubrandenburg for each of the four scenarios. The functionality of the assessment form and the four test scenarios was confirmed in the process. For data privacy reasons, audio recordings were not adopted. However, the assessment forms were completed by the test buyers immediately after visiting the pharmacies so that recall bias by the test buyers could be minimised.
After evaluating the data collection, each pharmacy was given individual performance feedback in which the particular pharmacy was assessed relative to the other anonymised competitors in the city of Neubrandenburg using benchmarking. This gave the pharmacies information about their competitive position so that ideally the pharmacies visited could implement appropriate optimisation processes based on this information with the aim of sustainably improving the quality of their advisory service.
The statistical software program SPSS 22 was used to record and analyse the data. The data obtained were initially analysed using descriptive statistics. In this model, each community pharmacy served as a level of a random factor while request and user group both served as fixed factors. Results were considered statistically significant if P values were less than 0.
The study was approved retrospectively by the local University ethics committee, which was established after the study had commenced.
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All 84 planned simulated patient visits were completed. At the level of the individual variables, assessing 21 pharmacies produced a mean score of 7.
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The mean scores varied greatly between 0. At the level of the pharmacy, across the total of 9 variables on the assessment form and the dichotomous coding for each test scenario, each pharmacy obtained a result between 0 points minimum and 9 points maximum. Across all four test scenarios, a mean score of 3.
The mean scores achieved varied greatly between 1. This enabled the data to be filtered for those pharmacies that knew who the particular user of the medication would be see supporting information Data S1 and Table S1. The most common information provided was about dosage, while the least common information given was about side effects. Significant differences were seen when comparing the product and symptom requests, but there was no effect resulting from different user groups and no interaction between the type of request and different user groups. It would therefore be useful if future studies are ideally based on an adequately large, randomised sample of pharmacies drawn from across Germany.
It must also be noted as a further limitation that only four test purchases were carried out in each pharmacy.
It would therefore be plausible to increase the number of test purchases per pharmacy for future studies. Because it cannot be ruled out that the test results varied depending on the particular test buyers used, it is also possible that evaluations by other test buyers would lead to different results. On the other hand, using only objective items avoided possible leeway in the assessments made by the test buyers.
This may have led to an increased reliability, but at the expense of validity. For example, pharmacy staff can ask questions in a great variety of quality, and reducing these to binary items conceals that real variability. Therefore, it was not possible to determine whether there are significant differences in the advice provided by pharmacists and pharmaceutical technical assistants.
Future studies should take this aspect into account, especially as there are contradictory study results in the international literature in this regard. In this study, clear potential was found for almost all Neubrandenburg pharmacies to optimise the quality of advice provided for acute diarrhoea in adults.
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Similar problems are also described in a recent Turkish study. Although the advice dispensed was only tested for the indication acute diarrhoea, other scientific studies in Germany of other indications such as headaches reveal that there is considerable room for improvement. Depending on the particular criteria investigated, there were clear differences apparent in the quality of the advice provided. Similar differences are also seen in the international literature. What was noticeable was that barely any information was requested about the medication history or any existing medical conditions, even though certain medications can cause diarrhoea.bbmpay.veritrans.co.id/alguazas-como-conocer-gente.php
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