C+D puts the scenarios that Which? used in their investigation – which found that two fifths of pharmacies deliver unsatisfactory medicines advice – to our own experts.
What would you have done in each case? Comment below
Which? mystery shoppers asked for something to treat diarrhoea that they'd had since their holiday. If asked, they said they had returned from a trip to south-east Asia.
● What happened Imodium or similar was offered in 14 out of 40 visits, 11 of which involved pharmacy staff only. Staff did not rule out a potentially serious infection in these cases.
● Which? said The pharmacist should have asked about their symptoms, the duration, the holiday location and whether the patient had seen a doctor. Anti-diarrhoeals or oral rehydration salts should only be given as an interim treatment. Patients should have been referred to their GP.
● Our expert said The patient should be questioned and sent to consult their GP, according to Kent pharmacist Amish Patel, irrespective of whether they had been on an exotic holiday or picked up a bug at home. He said patients could be given Imodium only as a short-term measure.
Mystery shoppers asked to buy Imigran Recovery for migraine.
● What happened Pharmacy staff on 12 out of 41 visits said the patient needed to see their GP for a migraine diagnosis before buying Imigran Recovery.
● Which? said Pharmacies should not sell this medicine without asking questions set out by the MHRA to check that the customer is experiencing migraine and the medication is suitable. Referring them was a potential waste of precious GP appointments but staff were not marked down for doing this.
● Our expert said Consultant neurologist Nick Silver said he would want to see if the patient had a history of known migraine. If the patient had not previously been prescribed the drug, Dr Silver said further questions should be asked, including the nature of the headache, any comorbidity, or anything that might indicate a more worrying cause for headache.
Mystery shoppers asked for Pantoloc Control for heartburn. If asked the shopper would have said they were on warfarin.
● What happened On 11 out of 17 visits the medication was sold without a single question being asked.
● Which? said The drug should only be sold after the pharmacist asks questions set out by the MHRA. Pantoloc Control can interfere with warfarin levels and the patient should be warned of this or told to see their GP before buying.
● Our expert said Rhona O'Neill, pharmacist at the NHS information centre at Guys and St Thomas' NHS Foundation Trust, said that, in light of the information in the BNF and SPC, a pharmacist should confirm that the patient is not taking warfarin before selling them the product. If a patient is taking warfarin the pharmacist should advise the patient to seek further advice before commencing treatment.
Source: Which? investigation, published May 20