In New Zealand there is a class of drugs (Restricted Medicines) which are available over the counter in pharmacies, but must be sold by qualified pharmacists. Patient names must be recorded for each sale. Many restricted medicines have recently been reclassified from prescription only, with the expectation that pharmacists provide professional input into their sale. The study described here explored whether pharmacists do fulfil this expectation.

In late 1999 twelve mystery shoppers made 360 visits to 180 pharmacies around New Zealand. The pharmacies were in 8 different geographical areas with different population characteristics (e.g. town size, levels of ethnic minority populations). Shoppers were of different ages, genders, ethnic and socio-economic backgrounds.

Mystery shoppers asked to purchase a restricted medicine and recorded the questions they were asked and the advice given to them. Pharmacists were informed that the study was happening, but did not know whether their pharmacy would be visited. A range of strategies were used to ensure shopper anonymity and these appear to have been very successful.

Two kinds of products were purchased: diclofenac 25mg (brand name Cataflam), which was requested for 'back pain' and vaginal anti-fungal requested for 'thrush'. Both Cataflam and some brands of vaginal anti-fungal are widely advertised direct to consumers in New Zealand. If asked, all shoppers said they had never had Cataflam before, but someone they knew had recommended it. If asked, women shoppers said they had had thrush some years before but could not remember what product they used.

The shoppers sometimes found it difficult to distinguish pharmacists from other pharmacy staff. However we are sure that in some instances non-pharmacist staff sold the restricted medicines. Some of the identification issues and the prevalence of non-pharmacists selling restricted medicines will be presented.

The paper will describe the level of counselling provided, for example, how often shoppers were asked about contraindications (stomach ulcers, asthma, allergies) when diclofenac was sold, how often women purchasing vaginal anti-fungal were asked about their symptoms, and how often shoppers were given advice about using any of the products. A scoring system was developed to assess how much counselling each pharmacy provided. This allows us to look at the proportions of pharmacies who provide a lot of counselling, those that provide some, and those that provide none.

The issues around recording of patient names will also be briefly discussed. Some pharmacies did not record patient names. Others used a variety of methods of recording, some of which had implications for patient privacy.