Algorithm for pharmacists from community pharmacies who dispense over-the-counter proton pump inhibitors and histamine receptor antagonists for patients reporting symptoms of reflux

Abstract

Pharmacists have been identified in the health care system as a professional group that should be responsible for the safety of pharmacotherapy, including pharmacotherapy recommended by the physician, as well as pharmacotherapy based on consultation with a pharmacist. Pharmacists play an important role in supervising patients' self-medication, including decisions related to the treatment of minor ailments. In Polish community pharmacies, pharmaceutical consulting is one of the essential services provided by professional staff. Decisions on drug selection during a pharmaceutical consultation should be based on available guidelines and recommendations regarding therapeutic procedures for specific diseases. Reflux disease (GERD) and peptic ulcer disease affect 20-40% of the population in highly developed countries. It is estimated that in Poland, up to 34% of adults have symptoms of this disease, of which about 10% go to a specialist when complications have already developed. Reflux disease treatment is based on using proton pump inhibitors (PPIs) or histamine H2 antagonists (AH2). Research conducted around the world after the introduction of PPIs for over-the-counter sales indicated an increase in the sale of these products and their inappropriate use. In Poland, PPIs constitute a significant part of pharmacies' sales, obliging pharmacists to supervise their correct use. This obligation may be facilitated by developing algorithms for dealing with various situations related to dispensing PPIs in a pharmacy. This article aims to present the rules for dispensing PPIs without a prescription for a patient reporting heartburn symptoms. The procedure includes verifying indications for use, selecting the drug and providing detailed information regarding its use. The algorithm can support the pharmacist in rationalising and facilitating correct procedures. The pharmacist should also prepare and present recommendations to the patient based on appropriate documents and guidelines. The algorithm may be an inspiration to prepare other tools to support work and improve the quality of pharmaceutical consulting provided in generally available pharmacies.

Keywords

• pharmaceutical consultation
• esophageal reflux
• proton pump inhibitor
• histamine h2 antagonist