Context

Consumers are increasingly being to adopt a philosophy of self care; the internet allows people to obtain advice about medicines at their own convenience. As the internet expands, there is great interest in the use of internet pharmacies in place of the local pharmacy. However, with a lack of face-to-face contact, and contact only in the form of e-mails, the quality and relevance of the advice given has been questioned ^1,2. Consequently, the main objective of this study was to assess whether the information provided by Internet pharmacy sites in response to questions posed by a mystery shopper ³ via e-mail on minor ailments is accurate and relevant.

Method

Three scenarios were devised, a request for St John's Wort for a woman taking oral contraceptives, a question regarding treatment of haemorrhoids and an enquiry about antimalarials for someone travelling to Laos and Vietnam. Questions were constructed and e-mailed to Internet pharmacy sites. A checklist was designed, using a response to symptoms textbook ⁴, containing information expected to be imparted by a pharmacist in response to the question. The advice given was compared to the checklist to determine its completeness and relevance. The email requests were sent to the eight main UK-based and eight US-based pharmacy sites.

Results

Nine replies were received for scenario one; only three of the replies highlighted the interaction with oral contraceptives although four sights referred the individual to their GP or pharmacist for further advice. Seven replies were received each for scenarios two and three. Just one site sent extra questions to better tailor the advice to one question, although four sites did require a form with individual details to be filled in. The other replies gave general information concerning the question, although occasionally this was combined with personalised advice. The number of checklist items covered varied quite widely between different scenarios. The overall number of sites replying was low, and some sites could not be contacted. Some replied but merely stated their inability to provide advice.

Discussion and Conclusion

Contacting the sites, and receiving replies from them, proved to be a hit-and-miss affair. For example some sites replied to one of the scenarios and not to the other two. The information received varied greatly among sites and was generally not comprehensive. Very few internet pharmacies provide the facility for customers to have a meaningful consultation with a pharmacist. The advice provided was often not individualised, although occasional references were made to individual circumstances. In a larger study involving a request for St John's wort only three pharmacies contacted the mystery shopper regarding a potential drug interaction ¹. There is a need for more customer focused services. Internet pharmacies must consider the quality their services and start to comply with standards that are being set by national pharmaceutical associations.

References

1. Bessell Tl, Anderson JN, Silagy CA et al Surfing, self medicating and safety: buying non-prescription and complementary medicines via the internet Qual Saf Health Care 2003 (Feb, In press)

2. Anderson Cm A call for internet pharmacies to comply with Quality standards Qual Saf Health Care 2003 (Feb, In press)

3. Goel P, Aross-Degnan D, McLaughlin T, Soumari S. Influence of location and staff knowledge on quality of retail pharmacy prescribing for childhood diarrhoea in Kenya. Int J Qual Healthcare 1996; 896): 519-52

4. Blenkinsopp A, Paxton P Symptoms in the Pharmacy. 2001.Blackwell Science Ltd Oxford.