Pharmacists' perceptions alone are no longer sufficient evidence of a robust counter prescribing process. The Royal Pharmaceutical Society's Practice Committee has issued guidance this week on counter prescribing for self-limiting minor illnesses and common conditions (p358). Before members rush to complain that the Society is seeking to "teach us to suck eggs (again)", it should be explained that the guidance is more about the processes being followed than the actual questions to be asked.
Thousands of pharmacists have counselled millions of patients over the years and sold them a multitude of over-the-counter medicines (or not, as appropriate). However, in the current climate of evidence-based practice and corporate governance, simply doing something is not enough. Evidence is needed that a structured process is in place, appropriate decisions are made and followed through and that records are kept where necessary.
Through its guidance, the Society is asking pharmacists to look at what happens in their pharmacies. Are the right questions asked? Is the right treatment sold (or not) and what happens afterwards? Pharmacists can (and should) make their own judgments about the questions to be asked and the products to be sold in individual circumstances, but there should be some evidence that a process has been followed.
Gathering evidence of counter prescribing might seem like another thankless task for overworked pharmacists, but those who do will soon see the benefits. Discussions with other health care professionals, and National Health Service bodies, will be enhanced when the pharmacist can say: "I counselled 1,507 customers last month and recommended OTC products to 73 per cent of them." Decision makers, who may not visit pharmacies on a regular basis, might then begin to get a better idea of the work put in by community pharmacists on a daily basis.