Author/Editor		Obreli-Neto, Paulo Roque; Régis Leira Pereira, Leonardo; Molino Guido, Camilo; de Oliveira Baldoni, André; Marušić, Srečko; Pereira de Lyra-Júnior, Divaldo; Luis de Almeida, Kelsen; Montolezi Pazete, Ana Claudia; Dutra do Nascimento, Janaina; Kos, Mitja; Girotto, Edmarlon; Cuman, Roberto Kenji Nakamura
Title		Use of simulated patients to evaluate combined oral contraceptive dispensing practices of community pharmacists
Type		članek
Vol. and No.		Letnik 8, št. 12
Publication year		2013
ISSN		Y506-0087 - PloS one (Združene države Amerike)
Language		eng
Abstract		Combined oral contraceptive (COC) use is the most commonly used reversible method of birth control. The incorrect use of COCs is frequent and one of the most common causes of unintended pregnancies. Community pharmacists (CPs) are in a strategic position to improve COC use because they are the last health professional to interact with patients before drug use. Objective To evaluatethe COC dispensing practices of CPs in a developing country. Method Across-sectional study was conducted in community pharmacies of Assis and Ourinhos microregions, Brazil, between June 1, 2012, and October 30, 2012. Four simulated patients (SPs) (with counseled audio recording) visited community pharmacies with a prescription for Ciclo 21Ž (a COC containing ethinyl estradiol 30 mcg + levonorgestrel 15 mcg). The audio recording of every SP visit was listened to independently by 3 researchers to evaluate the COC dispensing practice. The percentage of CPs who performed a screening for safe use of COCs (i.e., taking of patients¼ medical and family history, and measuring of blood pressure) and provided counseling, as well as the quality of the screening and counseling, were evaluated. Results Of the 185 CPs contacted, 41 (22.2%) agreed to participate in the study and finished the study protocol. Only 3 CPs asked the SP a question (1 question asked by each professional), and all of the questions were closed-ended, viz., do you smoke? (n = 2) and what is your age? (n = 1). None of the CPs measured the patient's blood pressure. Six CPs provided counseling when dispensing COCs (drug dosing, 5 CPs; possible adverse effects, 2 CPs), and one CP provided counseling regarding both aspects. Conclusion The CPs evaluated did not dispense COC appropriately and could influence in the occurrence of negatives therapeutic outcomes such as adverse effects and treatment failure.
Keywords		combined oral contraceptives community pharmacists simulated patients farmacevti javno zdravstvo terapevtični rezultati