Examining the influences on dispensing SABA in line with GINA guidelines in Brazil and Spain: An observational ethnographic study of over-the-counter interactions in pharmacy settings

Clinical Research Results Abstract Research Idea Abstract Research question:To what extent do pharmacists influence patients’ understanding, beliefs/attitudes of SABA over-use and over-reliance; and to what extent do pharmacy staff reinforce or challenge SABA overuse or over reliance.Background:GINA guidelines no longer recommend SABA monotherapy in asthma management, there is an over reliance on SABA amongst asthma patients and dispensing of this medication remains high in Spain and Brazil.Prescription is required for dispensing SABA but exceptions for emergency use may become habitual non-emergency use. Reasons could include stockpiling to manage asthma related anxiety, patient lacking knowledge of risks of overuse or low expectation of symptom management with ICS.Pharmacy staff may have a key role in reducing over-reliance and overuse of SABA. Understanding what happens in the communication between community pharmacists and patients/customers may offer ideas for how to improve these interactions for GINA compliance and better patient outcomes.Possible methodology: An ethnographic observational study design is the best method to answer our research question about the interactional aspects of dispensing pharmaceuticals in pharmacy settings. Pharmacies in Spain and Brazil will be sampled to represent a range of characteristics (location, size, population demographics). Data will be collected from pharmacies that agree to participate using observations of over-the-counter interactions, analysis of standard operating procedures, informal ethnographic interviews with actors in SABA dispensing event (including counter staff, technicians, pharmacists, patients) and formal semi-structured interviews with pharmacy staff. Data will be analysed using thematic analysis which allows for systematic comparison within and across settings.Questions to discuss:Do you agree that this study will provide what we need to achieve behavioural changes in the line of GINA guidelines?Protecting privacy and confidentiality is mandatory. What other ethical issues should we be considering? We would welcome advice from delegates familiar with pharmacy settings on barriers and enablers to recruitment. Service Development & Evaluation Abstract Declaration of Interest The development of the protocol has been funded by AstraZeneca. There is currently no funding to implement the protocol. References and Clinical Trial Registry Information