Non-prescription medicines for pain and fever--a comparison of recommendations and counseling from staff in pharmacy and general sales stores.

Objectives: The purpose of this study is to map and analyze the content and quality of the encounter when customers buy non-prescription medicines for pain and fever.

Methods: 297 pharmacies and 801 general sales stores (GSS) in Sweden were selected. A "Mystery shopper" exercise was conducted. Three scenarios were used and a total of 366 units were selected for each scenario. There were in total 625 observers: 208 in the child with fever scenario, 225 in the Reliv scenario, and 192 in the painkiller during pregnancy scenario.

Data Collection: 21st September to 20th November 2011.

Results: In two out of three visits to GSS, the staff proposed a medicine for a heavily pregnant woman. The staff suggested in 9% of the visits a medicine that is inappropriate in late pregnancy. The corresponding percentage in pharmacies was 1%. Both pharmacies and GSS proposed, in 6% a medicine that is inappropriate for babies to a feverish child. Only 16% of the pharmacists and 14% of the staff in GSS asked for the age of the child. General sales staff recommended in 10% ibuprofen and in 4% an acetylsalicylic acid product when an acetaminophen preparation was requested. The corresponding percentage in the pharmacy were 4% ibuprofen, 2% diclofenac, and 1% an acetylsalicylic acid product.

Conclusions: The staff in GSS and pharmacies do not pay sufficient attention to the heterogeneity of painkillers, which lead to inappropriate recommendations.