Responding to Requests of OTC Over The Counter Medicines Guide for Junior Pharmacists and Pharmacy Students
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esponding to symptoms in the pharmacy is a major role for the pharmacist. On average a community pharmacist will encounter 10-15 requests for advice about symptoms every day (the actual number varies according to location).
What is responding to symptoms?
It is the act of responding clinically to symptoms (health complaints) presented to the care of the pharmacist in a community setting. It includes identifying symptoms, reaching a decision to refer or treat the patient, and ensuring benefit of therapy if recommended. Individuals treat themselves to establish and maintain health, prevent and deal with illnesses, a process regarded in the health community as self-care. Self-care is a wide spread practice that includes: personal hygiene, nutrition, life style and so forth. Socio-economic factors are also involved in self-care. As a result, people may use non- prescribed medication on their own initiative (Self-medication).
Self-care and self-medication are commonly practiced by the public. Pharmacists must ensure that this practice is safe and beneficial to health. People present to community pharmacies requesting treatment for a condition and/ or a named product that may happen to be a prescription only medicine (POM).It is the responsibility of pharmacists to personally deal with such cases because they have been equipped with the appropriate knowledge and skills. Other members of the pharmacy team should not ideally be involved in advising people about self- medication/self- care.
How to deal with treatment requests
1. Identify the patient; find out who the patient is, age and gender. People can request medications on behalf of others.
2. Identify the problem; explore symptoms, signs, their duration and severity. Do not accept the diagnosis of the patient. 3. Take medicine and disease history; determine whether the patient has any other health conditions or using any medicines or home remedies. This includes identifying if the patient has used other medicines for the complaint. 4. Decide to treat or refer. Only minor conditions can be treated in the pharmacy. Infections and serious complaints MUST be referred to medical care. However, some help might be appropriate from the pharmacist before the patient gets to medical care centers. 5. Advice and counsel; explain to the patient your decision. It is useful to provide an explanation about the initial complaint and the role of therapy. Nonpharmacological measures may need to be recommended.
Here is mnemonic to help you remember how to deal with treatment requests: WWHAM W: Who is it for? W: What is it for? H: How long have the symptoms persisted? A: Action taken: what medicines have you already tried? M:Medicines used for other diseases. Antimicrobials (antibiotics, antimalarial, anthelmintic…) should never be dispensed without a prescription.
2. how much to take or use the medicine 3. how long to continue 4. warn the patients on serious adverse reactions likely to occur and what to do if such thing goes on 5. how to recognize side effects and minimize their incidence 6. life style and dietary changes which need to be made The above is the general procedure for undergoing any patients counseling but further advice might be needed for other groups like children, elderly, people with physical disabilities, pregnant ladies and those of chronic illness. Aids to counseling Patient information leaflets and warning cards are useful aids when giving advice to patients
Example:
Advice to patients on Diclofenac tablets • •
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The pharmacist can dispense medicines from the OTC list freely but should never dispense POM in response to requests by patients.
Counseling patients on medicines The purpose of counseling is to: 1. ensure that patients are adequately informed about their medication 2. pre-empt and identify any problems which might cause loss of efficacy of medications How to go about counseling 1. how and when to take and use the medicine
Federal Ministry of Health
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Diclofenac is used to relieve pain, particularly pain in the muscles and joints. The tablets/capsules should be swallowed whole with a drink of water or milk, not crushed or chewed. Avoid taking indigestion remedies for at least one hour before and after taking diclofenac. They can affect the special coating that makes the diclofenac work most efficiently. Some people have indigestion after taking diclofenac. To prevent this, diclofenac should be taken with or just after food. If indigestion or heartburn persists, you should contact your doctor. Other side effects that occasionally occur with diclofenac include diarrhoea, feeling sick, headache and dizziness. If you have severe indigestion (stomach pain), difficulty in breathing or a skin rash, stop taking the medicine and contact the doctor straight away. Problems can occur if diclofenac is taken with some other medicines. Are you taking any other prescribed medicines or medicines you have bought?
Federal Ministry of Health - Directorate General of Pharmacy National Medicines Information Centre and Reference Library Algama Street Tel. 0183749255, 0183772843 - Fax: 0183749256 Website: www.nmicrl.sd - www.sjrum.sd Email: nmicrl@gmail.com
Directorate General of Pharmacy