Characterizing Communication between Community Pharmacists and Older Children
Creators: name: Horowitz, Katherine
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2017

description: Background: The prevalence of chronic diseases in children has been increasing, with
an estimated 16.2% of children having at least one chronic condition. A previous study
that took place in community pharmacies found that younger children were counseled
more often than older children7. The current study seeks to build on the previous study
to define opportunities for intervention between community pharmacists and older
children (13-17 years). This study investigated the following questions: 1) What are the
best days of the week to intervene with children in a community pharmacy setting?; 2)
Do older children ask more questions regarding medications when they come to the
pharmacy with their caregivers versus without their caregivers?; 3) What types of
questions are most commonly asked by older children?; 4) What types of questions are
most commonly asked by caregivers?; 5) Is the number of questions asked to the
pharmacist impacted by the child’s gender?; 6) Do older children ask more questions
about their medications when prescriptions are new versus refill medications?; and 7)
How often do older children ask about over the counter (OTC) products when coming
into the pharmacy?
Methods: This observational study was conducted over a 21-day period with 14 days of
observation in one rural pharmacy and 7 days of observation in an urban community
pharmacy. A researcher used an observation guide to collect the following information
about prescriptions picked up for children 7-17 years of age: 1) if questions were asked
about prescriptions (yes/no), 2) who picked up the prescription, 3) and what day of the
week the prescription was picked up. Also data were collected on the types of over the
counter (OTC) products that were picked up with the prescription. In addition, data were
collected on the following demographic information: 1) caregiver gender and 2) child
age and gender. Medication name, dose, and duration of therapy were obtained from
the prescription. Chi-square tests were used to examine the impact of child age and
gender on whether any questions were asked. The two age groups were defined as
younger (7-12 years old) and older (13-17 years old). Fisher’s exact test was used to
evaluate if there was a difference in the number of children picking up a prescription for
an acute or chronic disease based on the pharmacy location (urban or rural).
Results: Fifty-six prescriptions were picked up during the observation period. No OTC
products were picked up together with these prescriptions. Regarding who picked up
the prescription, 63% were picked up by caregivers alone, 29% were picked up by
children and caregivers together, and 8% were picked up by children alone. Among 22
older children, 18% picked up their prescriptions alone without their caregiver. Children
and caregivers did not ask the pharmacist any questions during 81% of encounters.
Older children never asked the pharmacist any questions. Prescriptions were most likely
to be picked up on a Monday for younger children and most likely picked up on a Friday
for older children. The least likely days for a prescription to be picked up were on a
Saturday or Sunday regardless of child age or if the prescription was picked up at the
urban or rural pharmacy. Medications were most likely to be picked up for a child 7-17
years of age at the rural pharmacy on a Monday (p=0.001).
Conclusions: Pharmacists are limited in their ability to counsel children since caregivers
usually pick up their child’s prescriptions, and children infrequently visit the pharmacy
with their caregivers. Older children rarely visited the pharmacy alone and did not ask 
questions about their prescriptions. Based on the low observation of children visiting
community pharmacies, future studies could explore whether technology (smartphones
and tablets) would be a feasible and acceptable way for pharmacists to counsel older
children on medications.