Be Informed ... Stay Healthy ... Talk With Your Pharmacist

Amanda Lehenbauer, PharmD Candidate 2005
University of Missouri-Kansas City
Prepared during Consumer Health Information Corporation Summer Internship

McLean, VA

What do consumers think about their pharmacy? How much do they know about the important counseling services their pharmacist can provide? How often do they take advantage of these services?

Consumers are often told they play an important role in their drug therapy. As more new and expensive medicines become available, it is important that consumers get the most for their money, and that they understand how to take their medicines in order to get the most benefit from them. To do this, consumers need to ask specific questions about their medicine.

Are you playing an active role by asking the right questions of your pharmacist? Here is what you need to ask the pharmacist every time you visit:

What You Need To Ask Your Pharmacist

This helps you stay informed about your medicine so you can tell other doctors, pharmacists, and healthcare providers what you are taking.

Taking your medicine correctly is the first step to getting the most benefit from your medicine. You should know when to take it, how often to take it, whether to take it with or without food, and if you need to take it at the same time every day. It is also important to know how long you need to take the medicine.

It is important to inform the pharmacy of your drug allergies and to go to the same pharmacy for all of your prescriptions. By doing so, the pharmacist can check your Medication Record each time to make sure you do not receive a medication you might be allergic to.

It’s important to find out if certain foods or drinks (such as alcohol) affect the way your medicine works. If a medicine causes a side effect such as dizziness or drowsiness, you might have to be careful driving a car, operating dangerous machinery or doing any activities that could lead to an accident.

All medicines can cause side effects, no matter how minor. It is important to know the early warning signs of any side effect that might occur and how to manage them correctly.

A less expensive (generic) version of a brand name drug may be available. Taking a generic version can help cut your health care costs. 

Sometimes people forget to take their medicine. It is important to know what to do if this happens. 

Expectant and nursing mothers should always know what to expect before taking any medicine. Some drugs can cause birth defects and/or can pass through the mother’s milk to the baby.

• How do I store my medicine?

It is important to store medicine correctly. Medicine should not be stored near heat, moisture or light – such as the bathroom cabinet or the glove compartment of the car – because this can affect its strength. Ask your pharmacist about the proper place to store your medicine.

The Callaway County Survey

After reading these questions, do you feel like you are receiving enough information about your prescriptions? This past summer, a survey was performed in which over 300 Callaway County residents and employees rated their pharmacy experiences at independent pharmacies, chain drug stores and grocery store pharmacies. Fifty-eight people responded to the survey. Some of the survey questions and responses are as follows:

“What is the reason you chose this pharmacy?”

Location	Independent Pharmacy	Grocery Store	Chain Drugstore	Average
Insurance     Pharmacist       Pharmacist Services     Cost	37% 47% 42% 11%	44% 19% 13% 31%	68% 24% 8% 16%	50% 30% 21% 19%

Consumers said the two biggest factors in choosing their pharmacy were convenience in location and acceptance of their insurance. People who used the chain drugstores or grocery store pharmacies were more likely to do so because of the convenient location.

Pharmacist service was an important factor to people who visited the independent pharmacy. In general, only 21% of those replying to the survey said they chose to use their pharmacy because the pharmacist counsels them and answers their questions. When asked the question, “How important is it to speak with the pharmacist,” 80% said they felt it was important to talk to the pharmacist when picking up a prescription. This is a big difference between what people want and what they are getting. It is shocking that 80% feel this is important, but only 13% are choosing their pharmacy because of that reason.

“How often does your pharmacist give you advice on how to recognize early warning signs of possible drug side effects?”

Independent pharmacies score higher on how often pharmacists advise patients on the warning signs of side effects. Only 31% of consumers using grocery store pharmacies received this service, and worse, only 16% of those using chain drug stores were counseled. If you do not know what minor side effects to expect, you have a greater chance of having a serious side effect. Overall, there is a real need in all three types of pharmacies for patient communication.

Every time Sometimes Never	Independent Pharmacy	Grocery Store	Chain Drugstore	Average
	37% 32% 32%	31% 25% 38%	16% 36% 40%	28% 31% 36%

“How often does your pharmacist give you advice on how to manage any possible minor side effects?”

Close to 40% of Callaway County residents do not receive counseling on how to handle side effects they may experience. This could cause many to stop taking their medicine without their doctor’s consent, which could increase costs on healthcare services. This is why it is important to learn about side effects and how to manage them.

Every time Sometimes Never	Independent Pharmacy	Grocery Store	Chain Drugstore	Average
	26% 42% 32%	19% 38% 44%	12% 48% 48%	19% 43% 41%

“How often does your pharmacist give you advice on how to recognize signs of serious side effects that you need to call your doctor about?”

Most side effects are minor, but some side effects can be serious enough to require the advice of a doctor. Thirty-one percent of people in the survey did not know when to call the doctor. By doing so, this puts consumers at higher risk. State regulations require the pharmacist to offer to counsel patients on their medicines. It is disturbing that 31% never receive this counseling. Even though independent pharmacies received the highest ranking (37%), this is still not acceptable. Even though this is positive, it does not meet state regulations in which the pharmacist is required to offer to counsel the patient every time a prescription is filled. It is possible that some people refuse counseling because of being in a hurry or not needing the information.

Every time Sometimes Never	Independent Pharmacy	Grocery Store	Chain Drugstore	Average
	37% 42% 16%	19% 31% 44%	16% 40% 32%	24% 38% 31%

“How often does your pharmacist give you advice on how to know if the drug is working?”

In addition to asking about side effects, it is also important to know how to tell if a medicine is working. The purpose of a medicine is to help prevent an illness, relieve the symptoms of an illness, and increase your quality of life. Some illnesses have no symptoms, which makes it hard to know if your medicine is working. Almost half of those visiting grocery store and chain drug store pharmacies did not know how to tell if they were receiving the most benefit from their medicine. More than 47% did not know this information. As a consumer, it is very important that you know this information in order to decrease costs and increase your quality of life.

Every time Sometimes Never	Independent Pharmacy	Grocery Store	Chain Drugstore	Average
	21% 32% 37%	13% 25% 57%	4% 36% 48%	13% 31% 47%

What Callawegians Said About Their Pharmacy:

In addition to the survey results regarding information received at the pharmacy, there were several comments from residents about their counseling sessions with the pharmacist. One Callawegian felt it was imperative to speak with the pharmacist and planned to “arrange a few minutes to have a pharmacist look over the list of [medicines] a family member is taking to get suggestions on interactions, times taken, etc.”

In fact, many Callawegians placed a high value on the information their pharmacist provides. “The positive aspect of the pharmacy setting is that you are told about what you are taking,” said one. “The pharmacist wanted to talk with me and educate me about using an inhaler–good idea!” said another.

One parent said, “We usually call with questions concerning dosages for over-the-counter medications for our 4 and 5 year olds or with questions on side effects.”

A number of consumers in Callaway County said they preferred to use a local community pharmacy but used a mail-order service either because the prices were lower or their health insurance required it. Some noted that the lack of pharmacist counseling from the mail-order service was a drawback for them.

“Our daily medications are acquired three months at a time through our insurance mail order,” said one consumer, “but we use [a local pharmacy] for all one-time prescriptions.” Another said, “[The local] pharmacist is very friendly and good at remembering names and details about the person. I’m sorry I’m obligated to use the mail order pharmacy, but my family’s medications have gotten too expensive not to.”

The Need for Pharmacy Improvement:

What did consumers find annoying about a community pharmacy? Not being open long enough and long waiting periods were the top two complaints. These were followed by dealing with insurance companies and the pharmacy not having the medicine in stock.

One resident said the best way to improve the pharmacy would be to “include comfortable chairs and magazines in the waiting area” to make the delay more tolerable. Another suggested, “increasing the number of staff and pharmacy efficiency” to decrease wait time.

As a consumer, it is important to make the most of your pharmacy visit because you probably see the community pharmacist more often than any other member of the healthcare team. Over 67% of Callawegians said they visit their pharmacy at least once a month, which is more often than they visit their local physician.

“How would you rank your pharmacy’s performance in meeting your healthcare needs?”

Overall, Callaway County residents have a positive view of their pharmacy experience. Most respondents noted pharmacy care of independent pharmacies to be the best (79%) while chain drugstores received the worst ranking (40%).

Excellent Average Poor	Independent Pharmacy	Grocery Store	Chain Drugstore	Average
	79% 21% 5%	56% 44% 0%	40% 44% 12%	58% 36% 6%

The message is clear. Patients who do not receive the type of information they need to manage their medicines wisely could suffer form serious side effects. The best way you can take control is to take action and follow the steps in the “Be Pharmacy Smart” chart below in order to stay healthy, be informed and make the most of your pharmacy visit. Take advantage of the services provided at the pharmacy, stay informed, and keep healthy so that you may enjoy life to its fullest potential.

Be Pharmacy Smart

Here’s what you need to do to get the most benefit from your pharmacy visit and at no cost to you:

1. Choose your pharmacist with the same care as you would choose your physician. It is important to have a trusting relationship with your pharmacist.

2. Make sure your pharmacist knows all the prescription and nonprescription medicines you are taking, any allergic reactions you have had, health conditions, and current contact and insurance information. They need this information in order to help you get the most benefit from your medicines and protect you from medicine-related problems.

3. Try to fill all of your prescriptions at the same pharmacy. This allows the pharmacy to have a complete drug profile in order to check for drug interactions. This is especially important because many patients see several doctors, who may not always know all of the medicines being taken.

4. Check with your pharmacist before taking any nonprescription medicine. This will help to make sure that the over-the-counter medicine will not interact with your prescription medicines.

5. Do not leave the pharmacy until you have been able to talk with the pharmacist. If this is not possible, set up a time for your pharmacist to call you at home.

6. Always try to take your medicines at the right time and in the right way so that you  get the best treatment ... and keep your healthcare costs down. When a person does not take medicines the way they were intended, their health care costs usually soar. They usually need more doctor visits, more laboratory tests, more emergency room and hospital visits and more prescription drugs. They often lose time away from work because they are not feeling well or have to go to the doctor. The worst possible case is that they do not receive the full benefit of their medicine and die.

7. Do not share any of your medicines with family members or friends. Their health could be harmed if your medicines cause serious problems with their health condition.

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