OBJECTIVES : This study assessed medication counseling practices at retail chain pharmacies and evaluated the time associated with pharmacy staff and patient interaction and the type of the associated interaction.

METHODS : A blinded, cross-sectional, naturalistic, observational study was conducted at 33 pharmacies of retail chains (CVS, Walgreen, Walmart, Kroger, HEB, Randall’s and Target) selected randomly in the Houston area. Data was collected during Nov 2017 to Jan 2018 and each pharmacy was observed at least 3 times during different time periods of the day. The study was blinded to patients and pharmacy staff to avoid bias. Data was collected by trained observers utilizing an observational log, to record various parameters including patient wait time, duration of initial contact between patient and pharmacy staff. Indicators of counseling such as utilization of the counseling window and performance of show-and-tell (where the pharmacist demonstrates to patient on the usage of drugs by opening the pill bottles so that patient can associate what is being discussed with visual reference to the actual drug while offering counselling) were recorded and analyzed using SAS Version9.4.

RESULTS : A total of 153 interactions between patients and pharmacy staff were observed and recorded. The counseling window was utilized in only 4 of the observations (2.6%) and show-and-tell was not observed in any. The mean (± SD) interaction time in seconds for patients with pharmacists (137 ± 139 seconds) and that with pharmacy technicians (134 ± 63) was not significantly different (p>0.05).

CONCLUSIONS : The results suggest the absence of adequate counseling by a pharmacist (which is the requirement on all new prescriptions by the Texas State Board of Pharmacy). Further, the study found the average time spent by pharmacy staff was significantly less with their patients. Future extensive studies need to be conducted to evaluate the quality of pharmacy services and its value to patients.