Assessment of counselling for acute diarrhoea in German pharmacies: a simulated patient study

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The aim of this study was to assess the quality of counselling provided for acute diarrhoea and to evaluate the role of the patient's approach and different user groups in determining the outcome of counselling.


The simulated patient methodology was used in all 21 community pharmacies in a north-eastern German city. Four different scenarios related to self-medication of acute diarrhoea were developed and used in all the pharmacies (a total of 84 visits). The assessment form, completed immediately postvisit by the simulated patient, included 9 objective items scored using dichotomous scales to produce a scale from 0 to 9. After evaluating the data, every pharmacy received individual performance feedback to encourage behavioural changes and improve the quality of the counselling provided.

Key findings

Overall, the quality of counselling was poor (mean score of 3.3/9 (37%)). The most common information provided was about dosage (87% of interactions), while the least common information given was about side effects (4% of interactions). The main effect was seen when comparing the product and symptom requests (F(1,60) = 24.748, P < 0.001, ωp2 = 0.277). There was no effect resulting from different user groups (F(1,28) = 0.237, P = 0.630, ωp2 = −0.026) and no interaction between the type of request and different user groups (F(1,28) = 3.395, P = 0.076, ωp2 = 0.073).


This study highlighted the current deficits in appropriate counselling provided by community pharmacies in Germany.

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