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      The competency of Indonesian pharmacy students in handling a self-medication request for a cough: a simulated patient study

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          Abstract

          Background:

          Cough is a common symptom for which people frequently present to community pharmacies. Previous articles from developing countries have shown that the provision of self-medication consultation for cough in community pharmacies were suboptimal, with knowledge deficiency being a contributing factor. However, little is known regarding the ability of pharmacy students in handling self-medication consultations in developing countries.

          Objectives:

          To measure the competency of Indonesian pharmacy students in providing self-medication consultations for patients with chronic cough and to identify factors associated with the provision of appropriate advice.

          Method:

          This study is a cross-sectional study. A simulated patient method using a product and a symptom-based request of chronic cough was used in students from a pharmacy school in Indonesia. The nature and amount of information gathered and advice provided by pharmacy students were noted and audio-recorded. A logistic regression analysis was performed to identify factors associated with the provision of appropriate advice.

          Results:

          The information gathered by participating students was not comprehensive. The most common types of information gathered were related to the nature and duration of the cough. Information relating to accompanying symptoms, medications, and allergies was gathered in less than 60% of the participating students for both product and symptom based scenarios. The appropriate advice of direct medical referral was provided in 54% and 56% of the 183 participating students for the product and symptom-based request scenarios respectively. Asking about symptom duration and prior medical conditions were positively associated with the provision of appropriate advice in the symptom and product based requests respectively.

          Conclusion:

          Student competency in self-medication consultation for chronic cough needs to be improved. Appropriate information-gathering is a predictor of appropriate advice. Further qualitative research identifying factors affecting students’ competence in providing self-medication consultation is required, so that suitable interventions are developed and implemented.

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          Most cited references48

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          Prevalence, pathogenesis, and causes of chronic cough.

          Cough is a reflex action of the respiratory tract that is used to clear the upper airways. Chronic cough lasting for more than 8 weeks is common in the community. The causes include cigarette smoking, exposure to cigarette smoke, and exposure to environmental pollution, especially particulates. Diseases causing chronic cough include asthma, eosinophilic bronchitis, gastro-oesophageal reflux disease, postnasal drip syndrome or rhinosinusitis, chronic obstructive pulmonary disease, pulmonary fibrosis, and bronchiectasis. Doctors should always work towards a clear diagnosis, considering common and rare illnesses. In some patients, no cause is identified, leading to the diagnosis of idiopathic cough. Chronic cough is often associated with an increased response to tussive agents such as capsaicin. Plastic changes in intrinsic and synaptic excitability in the brainstem, spine, or airway nerves can enhance the cough reflex, and can persist in the absence of the initiating cough event. Structural and inflammatory airway mucosal changes in non-asthmatic chronic cough could represent the cause or the traumatic response to repetitive coughing. Effective control of cough requires not only controlling the disease causing the cough but also desensitisation of cough pathways.
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            What is a spiral curriculum?

            R Harden (1998)
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              Classification of Cough as a Symptom in Adults and Management Algorithms

              We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful?
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                Author and article information

                Contributors
                Journal
                Pharm Pract (Granada)
                Pharm Pract (Granada)
                Pharmacy Practice
                Centro de Investigaciones y Publicaciones Farmaceuticas
                1885-642X
                1886-3655
                Apr-Jun 2021
                28 April 2021
                : 19
                : 2
                : 2269
                Affiliations
                PhD. Lecturer. Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, University of Surabaya . Surabaya (Indonesia). cecilia.brata@ 123456gmail.com
                Mpharm. Lecturer. Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, University of Surabaya . Surabaya (Indonesia). stevenvictoria@ 123456staff.ubaya.ac.id
                MSc (Clin Pharm). Lecturer. Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, University of Surabaya . Surabaya (Indonesia). ekosetiawan.apt@ 123456gmail.com
                Mpharm. Lecturer. Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, University of Surabaya . Surabaya (Indonesia). bobbypresley@ 123456staff.ubaya.ac.id
                PhD. Senior Lecturer. Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, University of Surabaya . Surabaya (Indonesia). yosi_wibowo@ 123456staff.ubaya.ac.id
                PhD. Senior Lecturer. School of Pharmacy, Faculty of Medicine and Health, University of Sydney . Sydney (Australia). carl.schneider@ 123456sydney.edu.au
                Author notes

                Conceptualization: AK, JJ, ASL. Data curation: AS, DK. Formal analysis: AS, DK, ASL. Funding acquisition: AK, JJ. Investigation: AK, JJ, ASL. Methodology: AK, JJ, ASL. Supervision: AK. Validation: AK, ASL, JJ. Writing original draft: AS, AK. Writing review & editing: AK, AS, ASL, JJ, DK.

                Author information
                https://orcid.org/0000-0001-7437-8207
                https://orcid.org/0000-0003-4256-9206
                https://orcid.org/0000-0002-8147-5571
                https://orcid.org/0000-0002-4452-0820
                https://orcid.org/0000-0002-8871-2656
                https://orcid.org/0000-0002-2921-5609
                Article
                pharmpract-19-2269
                10.18549/PharmPract.2021.2.2269
                8118600
                bffa8a5f-d9f4-4e69-83c1-f1df8fe17260
                Copyright: © The Authors

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 02 January 2021
                : 11 April 2021
                Funding
                Funded by: The University of Surabaya Institute of Research and Community Services
                Categories
                Original Research

                cough,antitussive agents,self medication,referral and consultation,students, pharmacy,pharmacists,patient simulation,logistic models,multivariate analysis,indonesia

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