Mystery shopper study flawed

The Australian College of Pharmacy has challenged the validity of conclusions drawn from the recent International Journal of Clinical Pharmacy

publication describing a ‘mystery shop’ of Sydney community pharmacies (W 13 Jul), which doctors claim showed low rates of appropriate referrals to general practitioners.

The study showed “up to 50%” of pharmacies failing to recognise red-flag referral symptoms at first presentation, but Australian College of Pharmacy education and research manager Dr Brett MacFarlane said “the College has extensive experience in pharmacy mystery shopper research over many years and has published evidence of the profoundly positive effects Australian pharmacists have on patient care.”

MacFarlane highlighted the work was a pilot study, with the rate of referral only a secondary outcome, and it included only 13 out of the 5,600 pharmacies in Australia, not a representative sample.

The shoppers and the scoring sheet were not validated, he said, and some audio recordings of visits failed, meaning data recall was prone to bias.

Referral rates actually increased to 70% in two of the three clinical scenarios investigated, with the overall rate at 66%, and when a pharmacist was involved, 80%.

College president Georgina Twomey noted that pharmacy was one of the only professions in Australia that had competency standard based education.

“The pharmacy profession has a long history of supporting research into the quality of our clinical practice and welcomes any opportunity to undertake quality improvement.

“The College welcomes discussion over the role of pharmacists in front line clinical care,” she said, supporting an interdisciplinary team approach to healthcare and the ongoing close relationship between pharmacists and doctors.

“I call for a mature, evidencebased debate,” Twomey concluded.