Development of protocols for the provision of headache and back-pain treatments in Maltese community pharmacies

Abstract

Objective: The purpose of this study was to draw up two protocols designed to help Maltese pharmacists care for consumers seeking treatment for headache and back pain and to subsequently use the protocols to assess pharmacists’ management of the named conditions. Method: The setting was a sample of 10 of the 207 community pharmacies in Malta. Two flow-chart protocols for headache and back-pain management were developed from various reference sources. The protocols were first tested in a community pharmacy for practicality and applicability in a pilot study. In nine other pharmacies chosen at random the pharmacists’ manner of addressing 10 headache and 10 back-pain cases in each pharmacy was compared with that recommended in the protocols. Consumers who visited the pharmacy to fill a prescription, to purchase a named product or for advice on how to deal with symptoms wereincluded in the study. Key findings: Of the 212 pharmacist interventions assessed, cases where pharmacists responded to symptoms were managed with the highest average compliance (57%) whereas cases in which the consumer asked for a product by name were managed with an average compliance with the protocols of 46%. Cases in which consumers presented at the pharmacy with a prescription were managed with an average compliance of 55%. Conclusions: Protocols may be used as a means of measuring the impact of the intervention of community pharmacists in patient care. The findings suggest a lack of advice given to consumers presenting at the pharmacy to request a named product.