Pharmacist Adherence to Therapeutic Guidelines on Diagnosis and Treatment Provision

This project aimed to seek evidence on whether over-the-counter medication dispensing behaviour complies or conflicts with the protocols indicated in practice standards and guidelines of a national professional pharmacy organisation. 

Why is this important?

Overuse and underuse in general medical expenditure is a pressing dilemma identified by medical professionals globally, and in need of wide-ranging solutions. In fact the largest growing cost to governments and individuals in Australia over the past 20 years has been health expenditure.

In 2013-2014 subsidised pharmaceutical expenditure exceeded $10.1 billion, second only to medical services. In the same period spending on private prescriptions and over-the-counter (OTC) medicines was $9.7 billion; 93% being paid by individuals (Australian Institute of Health and Welfare, 2014). The market for all prescriptions and OTC medicines being worth more than $19.76 billion, which equated to 1.4% of Australian Gross Domestic Product (GDP) for 2014.

The frequency of this problem across different markets, countries and health sectors shows there is systematic failure in health care delivery (Brownlee et al. 2017; Saini et al. 2017). And the implications of inappropriate care have significant flow-on effects to global public health policy, not to mention the individual patients and health sector workers involved.

What did we do?

In this study we developed a field experiment with simulated patients to assess pharmacy over-the-counter compliance in diagnosis and treatment using therapeutic guidelines as a clinical benchmark.

What did we find out?

Although the market for dispensing over-the-counter medication in Australia is regulated, relatively high rates of overtreatment and some cases of undertreatment were observed in this study. Given the unintended adverse effects, including overuse of antibiotics and corticosteroids, these observations suggest the advisability of regulatory intervention ensuring compliance with professional protocols.