Experience of community pharmacists in providing advice about vulvo-vaginal complaints
Grinceviciene, S1; Vaitkiene, D2; Sukovas, A2; Grincevicius, J3; Celiesiute, J2
1: Vilnius University, Lithuania; 2: The Lithuanian University of Health Sciences (LSMU), Department of OB/Gyn, Lithuania; 3: Vilnius University, Medicine faculty, Lithuania
BACKGROUND: Many over-the counter drugs are available for treatment vulvo-vaginal complaints. Choosing for self-diagnosis and self-medication can contribute to delayed diagnosis and improper treatment. Pharmacists are the gatekeepers for rational self-medication and refering. However, it is not clear which barriers they meet and which advantages they use during consultations.
OBJECTIVE: To analyze the experiences of community pharmacists advising on vulvo-vaginal complaints.
METHODS: A qualitative study to evaluate pharmacists experience in providing advice about vulvo-vaginal complaints was conducted from January to March 2015. New respondents were included till saturation was achieved. Twenty-one Lithuanian community pharmacists were interviewed, recorded and transcribed verbatim. The qualitative content analysis approach was used for data collection during semi-structured interviews and for data analysis. Interview transcripts and documents were content analyzed independently by 2 researchers. Consensus was reach during negation in cases of disagreement. Thematic coding of narratives was performed, data was categorized into hierarchic tree.
RESULTS: Four main areas of special attention emerged: Provision of the service; uncertainty during counseling, collaboration with other health care providers and gatekeeping.
Despite wide use of over-the counter drugs for vulvovaginitis, pharmacists recognize their limitations for proper diagnosis and try to implement their gatekeeper role through providing reference to a physician, education of patients about the necessity to establish a diagnosis, and discussing possible complications resulting from irrational treatment. Pharmacists seeks to improve their service through collaboration with other healthcare providers. The main topics of advice are information on use, drug-drug interaction, adverse reactions, the spectrum of choices. While providing the service pharmacists feel uncomfortable to discuss the sexual history. They also face lack of confidentiality and lack of skills for counseling about sexual behavior during treatment.
CONCLUSION: Pharmacists feel uncomfortable while providing service for women with vulvo-vaginal symptoms, because of uncertainty of diagnoses, lack of confidentiality and insufficient skills in sexual counseling. Improvement of skills in sexual counseling about self-medication aspects could be helpful for pharmacist – patient interaction.
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