Impact of pharmaceutical counseling in minor health problems in rural Portugal

  • Raquel Coelho
  • Filipa A. Costa
Keywords: Nonprescription Drugs, Counseling, Community Pharmacy Services, Professional Practice, Pharmacists, Portugal


Objectives: The objectives of this study were to determine the prevalence of self-medication and to evaluate the clinical impact of pharmaceutical counseling.

Methods: A cross-sectional study was used with a prospective component, the latter to evaluate the impact of pharmaceutical counseling . The study was conducted in a rural community pharmacy for 14 consecutive days in December 2012, recruiting all individuals who agreed to participate and met the eligibility criteria. During a face-to-face direct interview demographic and clinical characteristics of patients were registered, followed by a pharmaceutical intervention, which consisted of evaluating the symptoms, selecting the most appropriate non-prescription medicine (NPM) available and advising the patient on pharmacologic and non-pharmacologic measures, all according to established protocols for minor health problems. When appropriate, the patient was referred to a medical appointment. One week later, the clinical outcome of such intervention was measured by asking the patients about the resolution of their minor health problems.

Results: Data from 298 patients were analyzed, the majority being female (60.1%) with an average age of 44.84 years (SD=22.41). Respiratory problems were the most frequent (n=78; 26.2%) and respiratory tract medication was the most frequently indicated (n= 77; 27.8%). The observed prevalence of self-medication was 40.7%. Of the 271 patients’ beneficiaries of pharmaceutical counseling, 86.8% had their minor health problems solved after one week (ranging from 77.5% to 88.2% according to a sensibility analysis for drop-outs).

Conclusions: This work is important as it demonstrates the beneficial impact of pharmaceutical counseling, a very relevant area for the pharmacist and where literature is particularly scarce.


Download data is not yet available.

Author Biography

Raquel Coelho


1. Soares MA. Medicamentos não prescritos – aconselhamento farmacêutico. Associação Nacional das Farmácias. Publicações Farmácias Portuguesas, Lisboa. 2002; 2ª edição: 27-114.

2. Despacho nº17690/2007, de 23 de Julho. INFARMED - Gabinete Jurídico e Contencioso. Legislação Farmacêutica Compilada. Lisboa.

3. Naves J, Castro L, Carvalho C, Merchán-Hamann E. Self-medication: a qualitative approach of its motivations. Cien Saude Colet. 2010;15(Suppl 1):1751-1762

4. Bosse N, Machado M, Mistry A. Efficacy of an over-the-counter intervention follow-up program in community pharmacies. J Am Pharm Assoc (2003). 2012;52(4):535-540. doi: 10.1331/JAPhA.2012.10093

5. Decreto-Lei n.º 176/2006, de 30de Agosto. INFARMED – Gabinete Jurídico e Contencioso. Legislação Farmacêutica Compilada. Lisboa.

6. Martins A, Miranda A, Mendes Z, Soares M, Ferreira P, Nogueira A. Self-medication in a Portuguese urban population: a prevalence study. Pharmacoepidemiol Drug Saf. 2002;11(5):409-414.

7. Melo M, Madureira B, Ferreira A, Mendes Z, Miranda A, Martins A. Prevalence of self-medication in rural areas of Portugal. Pharm World Sci. 2006;28(1):19-25.

8. Figueiras A, Caamaño F, Gestal Otero-JJ. Sociodemographic factors related to self-medication in Spain. Eur J Epidemiol. 2000;16(1):19-26.

9. Schimd B, Bernal R, Silva NN. Self-medication in low-income adults in Southeastern Brazil. Rev Saude Publica. 2010;44(6):1039-1045.

10. Vosgerau MZ, Soares DA, Souza RK, Matsuo T, Carvalho GS. Consumption of medicines by adults within an area covered by a family health unit. Latin Am J Pharm. 2011;16(1):1629-1638.

11. Ordem dos Farmacêuticos. Boas Práticas Farmacêuticas para a farmácia comunitária. Conselho Nacional da Qualidade. 2009; 3ª edição.

12. Ordem dos Farmacêuticos. Linhas de orientação – Indicação Farmacêutica. Elaborado pelo Grupo das Boas Práticas de Farmácia – Grupo do Guincho, Fevereiro 2006.. Available at: (accessed in 10.11.2012).

13. Galán T. El rol del farmacéutico en automedicación. Uso de medicamentos: análisis desde la experiencia en España. Pharm Care Esp. 1999;1:157-164.

14. Faus MJ, Amariles P, Martínez Martinez F. Atención Farmacéutica - conceptos, procesos y casos práticos. Pharm Care Esp. 2007;8:85-106.

15. Centro Andaluz de Documentación e Información del Medicamento. Automedicación: Riesgos y benefícios. Boletín Terapeutico Andaluz. 1996;12(5):17-18.

16. Krishnan HS, Schaefer M. Evaluation of the impact of pharmacist´s advice giving on the outcomes of self-medication in patients suffering from dyspepsia. Pharm World Sci. 2000;22(3):102-108.

17. Sclar DA, Robison LM, Skaer TL. Pharmacy consultation and over-the-counter medication purchasing outcomes. J Clin Pharm Ther. 1996;21(3):177-184.

18. Benrimoj SI, Werner JB, Raffaele C, Roberts AS, Costa FA. Monitoring quality standards in the provision of non-prescription medicines from Australian Community Pharmacies: results of a national programme. Qual Saf Health Care. 2007;16(5):354-358.

19. Wazaify M, Al-Bsoul-Younes A, Abu-Gharbieh E, Tahaineh L. Societal perspectives on the role of community pharmacists and over-the-counter drugs in Jordan. Pharm World Sci. 2008 Dec;30(6):884-91. doi: 10.1007/s11096-008-9244-1

20. You JH, Wong FY, Chan FW, Wong EL, Yeoh E. Public perception on the role of community pharmacists in self-medication and self-care in Hong Kong. BMC Clin Pharmacol. 2011;11:19. doi: 10.1186/1472-6904-11-19

21. Holland R, Desborough J, Goodyer L, Hall S, Wright D, Loke YK. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. Br J Clin Pharmacol. 2008;65(3):303-316.

22. Royal S, Smeaton L, Avery AJ, Hurwitz B, Sheikh A. Interventions in primary care to reduce medication related adverse events and hospital admissions: systematic review and meta-analysis. Qual Saf Health Care. 2006;15(1):23-31.

23. Patterson SM, Hughes C, Kerse N, Cardwell CR, Bradley MC. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2012;5:CD008165. doi: 10.1002/14651858.CD008165.pub2

24. Christensen M, Lundh A, Medication review in hospitalised patients to reduce morbidity and mortality. Cochrane Database Syst Rev. 2013;2:CD008986. doi: 10.1002/14651858.CD008986.pub2

25. Ryan R, Santesso N, Lowe D, Hill S, Grimshaw J, Prictor M, Kaufman C, Cowie G, Taylor M. Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews. Cochrane Database Syst Rev. 2014;4:CD007768. doi: 10.1002/14651858.CD007768.pub3

26. Martins S, Costa FA, Caramona M. Implementação de cuidados Farmacêuticos em Portugal, seis anos depois. Rev Port Farmacoter. 2013;5:7-15.

27. Hughes CM, Hawwa AF, Scullin C, Anderson C, Bernsten CB, Bjornsdóttir I, Cordina MA, Costa FA, Wulf ID, Eichenberger P, Foulon V, Henman MC, Hersberger KE, Schaefer MA, Sondergaard B, Tully MP, Westerlund T, McElnay JC. Provision of pharmaceutical care by community pharmacists: a comparison across Europe. Pharm World Sci. 2010;32(4):472-87. doi: 10.1007/s11096-010-9393-x

28. Censos 2011 – Resultados Definitivos Alentejo, Instituto Nacional de Estatística. Portugal. Available at: (accessed in 10.11.2012).

29. Watson MC, Bond CM, Grimshaw JM, Johnston M. Factors predicting the guideline compliant supply (or non-supply) of non-prescription medicines in the community pharmacy setting. Qual Saf Health Care. 2006;15(1):53-57.

30. Garner M, Watson MC. Using linguistic analysis to explore medicine counter assistants' communication during consultations for nonprescription medicines. Patient Educ Couns. 2007;65(1):51-57.

31. Soares MA. Automedicação versus indicação farmacêutica. Mundo Farmacêutico, nº18; 2005.

32. Ordem dos Farmacêuticos. Indicação Farmacêutica no uso racional dos medicamentos não sujeitos a receita médica. Protocolo da Febre. Linhas de Orientação. 2006; Lisboa. Consulted in 01.11.2012. Available at: (accessed in 10.11.2012).

33. Boletins de Farmácia Prática.. Available at: (accessed in 10.11.2012).

34. World Health Organization. Guidelines for ATC classification and DDD assignment 2013. Norwegian Institute of Public Health. Oslo; WHO:2012.

35. Stein CM, Gora NP, Macheka BM. Self-medication in urban and rural Zimbabwean communities. Br J Clin Pharmacol. 1989;27(6):741-747.

36. Major C, Vincze Z. Consumer habits and interests regarding non-prescription medications in Hungary. Fam Pract. 2010;27(3):333-8. doi: 10.1093/fampra/cmp105

37. Wilbur K, Salam SE, Mohammadi E. Patient perceptions of pharmacist roles in guiding self-medication of over-the-counter therapy in Qatar. Patient Prefer Adherence. 2010;4:87-93.

38. Rutter P, Wadesango E. Does evidence drive pharmacist over-the-counter product recommendations? J Eval Clin Pract. 2014;20(4):425-8. doi: 10.1111/jep.12157

39. Ngwerume K, Watson M, Bond C, Blenkinsopp A. An evaluation of an intervention designed to improve the evidence-based supply of non-prescription medicines from community pharmacies. Int J Pharm Pract. 2014 May [Epub ahead of print].

40. Mesquita AR, de Oliveira Sá DA, Santos AP, de Almeida Neto A, Lyra DP Jr. Assessment of pharmacist´s recommendation of non-prescription medicines in Brazil: asimulated patient study. Int J Clin Pharm. 2013;35(4):647-655. doi: 10.1007/s11096-013-9787-7

41. Xu T, de Almeida Neto AC, Moles RJ. A systematic review of simulated-patient methods used in community pharmacy to assessthe provision of non-prescription medicines. Int J Pharm Pract. 2012;20(5):307-319. doi: 10.1111/j.2042-7174.2012.00201.x
Original Research