Community pharmacists' treatment patterns and counselling of acute diarrhea in children: A simulation-based
1Department of Pharmacy Practice, College of Pharmacy, Qassim University, Saudi Arabia.
Insights
Community pharmacists in Yemen showed gaps in managing childhood diarrhea. They performed poorly in simulations, with inadequate assessment, counseling, and oral rehydration solution recommendations.
Area of Science:
- Pharmacy practice
- Pediatric health
- Global health
Background:
- Diarrhea is a major cause of child mortality globally, especially in resource-limited and conflict-affected regions like Yemen.
- Acute diarrhea in children under five years remains a significant public health concern worldwide.
Purpose of the Study:
- To evaluate community pharmacist treatment patterns for acute childhood diarrhea in Yemen.
- To assess the quality of counseling provided by pharmacists regarding pediatric diarrhea management.
Main Methods:
- A simulation-based cross-sectional study was conducted in Sana'a city, Yemen.
- Community pharmacists were assessed using questionnaires and simulated client methods.
- Evaluation focused on case assessment (age, diarrhea frequency, fever, blood/mucus), recommendations, and counseling.
Main Results:
- Only 3% of pharmacists used all five key indicators during simulated client interactions, contrasting with 43% in questionnaires.
- Oral rehydration solution (ORS) recommendations were inadequate in simulations (6% alone, 47% with other drugs), with 40% dispensing only antibiotics.
- Counseling quality differed significantly, with 89% reporting adequate explanation in questionnaires versus only 36% in simulations.
Conclusions:
- Community pharmacists in Yemen demonstrated insufficient evaluation of children with acute diarrhea in simulated scenarios.
- Pharmacists provided inadequate dietary advice and insufficient recommendations for oral rehydration solution (ORS).
- There was a notable discrepancy between pharmacists' self-reported practices and their actual performance in simulated patient encounters.
Background:
Diarrhea is a significant global health concern, particularly among children, and its impact is particularly pronounced in countries with limited resources and ongoing conflicts, such as Yemen. Diarrheal diseases remain one of the leading causes of morbidity and mortality in children under the age of 5 years worldwide.
Objectives:
The aim of our study is to assess the treatment patterns and counseling of community pharmacists regarding the management of acute diarrhea in children in Yemen.
Design:
A simulation-based cross-sectional study was carried out targeting community pharmacy professionals in Sana'a city.
Methods:
A questionnaire and simulated client methods were used to assess the pharmacists' evaluation of a case based on five indicators including the child's age, diarrhea frequency, presence of fever, and blood or mucus. In addition, the pharmacists' recommendations and counseling were also evaluated.
Results:
During the study, a total of 100 pharmacists were visited and evaluated using both a questionnaire and simulation. The results demonstrated that 43.0% of the pharmacists utilized all five indicators in the questionnaire, with a mere 3.0% using all five indicators in the simulation. Oral rehydration solution (ORS) alone was recommended by 42.0% of the pharmacists and in combination with other drugs by 47.0% in the questionnaire, and the rest (11.0%) recommended only other drugs; while in the simulation, 7.0% of the pharmacists referred the patients to clinic, only 6.0% recommended ORS alone, 47.0% gave ORS plus other drugs including antibiotics, and 40.0% dispensed only antibiotics. In regards to counseling, 89.0% of pharmacists reported that they would explain to the patient regarding the recommended medicine during the questionnaire, and only 36.0% gave any sort of explanation to the simulated client.
Conclusion:
In the current study, community pharmacists did not ask enough questions to accurately evaluate a child with acute diarrhea during the simulation. This finding has apparently differed from their responses in the questionnaire. Furthermore, the pharmacists failed to provide sufficient dietary advice, and their recommendation of ORS was inadequate.
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