PMID- 25972205
OWN - NLM
STAT- MEDLINE
DCOM- 20160901
LR  - 20181113
IS  - 2210-7711 (Electronic)
VI  - 37
IP  - 5
DP  - 2015 Oct
TI  - Non-prescription treatment of NSAID induced GORD by Australian pharmacies: a 
      national simulated patient study.
PG  - 851-6
LID - 10.1007/s11096-015-0129-9 [doi]
AB  - BACKGROUND: Patients regularly present to community pharmacies for advice about 
      and treatment for reflux symptoms and NSAIDs are a common cause of these 
      symptoms. There is no published literature detailing the approach that pharmacies 
      take to these enquiries, the pharmacotherapy they recommend or whether they 
      contribute to the safe and effective use of reflux medicines. OBJECTIVES: To 
      assess in an observational study design the clinical history gathering, 
      recommendations for GORD management and counselling provided by community 
      pharmacies in a simulated patient scenario involving suspected NSAID induced 
      reflux symptoms. Setting Australian community pharmacies. METHOD: Simulated 
      patients visited 223 community pharmacies to request treatment for reflux 
      symptoms. The interaction was audiotaped and assessed against guidelines for the 
      treatment of reflux symptoms. MAIN OUTCOME MEASURES: Alignment of community 
      pharmacies with international expert gastroenterologist guidance and national 
      professional practice guidelines for the treatment of reflux symptoms by 
      pharmacists including: consultation with a pharmacist; confirmation of reflux 
      diagnosis based on symptoms; recommendation of short courses proton pump 
      inhibitor (PPI) therapy; advice on the safe and effective use of reflux medicines 
      and referral to a doctor for further assessment. RESULTS: Pharmacists consulted 
      with the simulated patient in 77% of cases. Symptoms were enquired about in 95% 
      of cases and a medicines history taken in 69% of cases. Recommendations for 
      treatment included: PPIs (18%), histamine H2 antagonists (57%) and antacids 
      (19%). Advice on product use was given in 83% of cases. Referral to a doctor to 
      discuss reflux symptoms was made in 63% of cases. CONCLUSION: When assessing 
      patients for the symptoms of GORD, Australian pharmacists and non-pharmacist 
      support staff take a comprehensive history including symptomatology, duration of 
      symptoms, concomitant medicines and medical conditions and any GORD treatments 
      previously trialled. They provide comprehensive counselling on the use of 
      antisecretory and antacid medicines. Counselling could involve more comprehensive 
      information on lifestyle approaches for GORD management and side effects of 
      antisecretory and antacid medicines. Further alignment with guidelines for the 
      management of GORD would result in greater referral to a doctor for assessment of 
      recurrent GORD and greater recommendation of PPIs for symptoms. However alignment 
      with guidelines by all pharmacists is unrealistic if the guidelines are not 
      universally available to them.
FAU - MacFarlane, Brett
AU  - MacFarlane B
AD  - Australian College of Pharmacy, Level 2, 9/65 Tennant St, Fyshwick, ACT, 2609, 
      Australia. brett.macfarlane@acp.edu.au.
FAU - Matthews, Andrew
AU  - Matthews A
AD  - Pharmacy Guild of Australia, Level 2, 'Pharmacy Guild House' 15 National Circuit, 
      Barton, ACT, 2600, Australia.
FAU - Bergin, Jenny
AU  - Bergin J
AD  - Australian College of Pharmacy, Level 2, 9/65 Tennant St, Fyshwick, ACT, 2609, 
      Australia.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20150514
PL  - Netherlands
TA  - Int J Clin Pharm
JT  - International journal of clinical pharmacy
JID - 101554912
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Gastrointestinal Agents)
RN  - 0 (Nonprescription Drugs)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
MH  - Australia
MH  - Community Pharmacy Services
MH  - Female
MH  - Gastroesophageal Reflux/*chemically induced/*drug therapy
MH  - Gastrointestinal Agents/*therapeutic use
MH  - Guideline Adherence
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nonprescription Drugs/*therapeutic use
MH  - Patient Simulation
OTO - NOTNLM
OT  - Australia
OT  - GORD
OT  - Guidelines
OT  - Over the counter
OT  - Proton pump inhibitors
OT  - Reflux
OT  - Simulated patients
EDAT- 2015/05/15 06:00
MHDA- 2016/09/02 06:00
CRDT- 2015/05/15 06:00
PHST- 2014/10/01 00:00 [received]
PHST- 2015/04/27 00:00 [accepted]
PHST- 2015/05/15 06:00 [entrez]
PHST- 2015/05/15 06:00 [pubmed]
PHST- 2016/09/02 06:00 [medline]
AID - 10.1007/s11096-015-0129-9 [pii]
AID - 10.1007/s11096-015-0129-9 [doi]
PST - ppublish
SO  - Int J Clin Pharm. 2015 Oct;37(5):851-6. doi: 10.1007/s11096-015-0129-9. Epub 2015 
      May 14.