A qualitative study on community pharmacists’ decision-making process when making a diagnosis.
By: Sinopoulou V, Summerfield P, Rutter P.
Journal of Evaluation in Clinical Practice 2017 Dec;23(6):1482-1488.
Self-care policies are increasingly directing patients to seek advice from community pharmacists. This means pharmacists need to have sound diagnostic decision-making skills to enable them to recognise a variety of conditions. The aim of this study was to investigate the process by which pharmacists manage patient signs and symptoms and to explore their use of decision-making for diagnostic purposes. Pharmacists were asked to share their experiences on how they performed patient consultations and more specifically how they would approach a hypothetical headache scenario. Eight interviews were conducted with pharmacists who had a wide range of working practice. The pharmacists’ main motivations during consultations were product selection and risk minimisation. Their questioning approach and decision-making relied heavily on mnemonic methods. This led to poor quality information gathering, although pharmacists acknowledged they needed to delve deeper, but were often unable to articulate how or why. Some pharmacists exhibited elements of clinical reasoning in their consultations, but this seemed, mostly, to be unconscious and subsequently applied inappropriately.