# Exploring the effect of training community pharmacy staff in mentalization-based communication on recognizing patients' drug related problems: an uncontrolled pre-post intervention study in Denmark and the Netherlands

## TL;DR

This study explores how training pharmacy staff in mentalization-based communication affects their ability to identify drug-related problems during patient interactions.

## Contribution

The study introduces a mentalizing education program for pharmacy staff and evaluates its impact on recognizing drug-related problems in real-world settings.

## Key findings

- The overall increase in recognized drug-related problems was not statistically significant, but a significant increase was observed in the Netherlands.
- Categories like 'compliance' and 'monitoring' increased, while 'drug selection' and 'over/under dose' decreased.
- Referrals to other healthcare providers dropped significantly in Denmark after the intervention.

## Abstract

To explore the effect of a comprehensive mentalizing education programme on pharmacy staff's ability to recognize drug related problems (DRPs) during counter conversations in community pharmacies.

A multicentre, uncontrolled pre-post-intervention study was conducted in Danish and Dutch pharmacies. Over four months, pharmacists and pharmacy technicians completed a parttime mentalizing education programme. Participants documented all DRPs they recognized during six hours of counter conversations before and after the intervention. Data were analysed using mixed multilevel logistic regression, including a post-hoc comparison between countries.

Forty-one participants from twenty pharmacies registered 2507 conversations. The overall increase of recognized DRP frequency from 17.5% to 22.1% was not significant (p = 0.086). Post-hoc analysis showed a significant increase in the Netherlands (10.6%, p = 0.04). Recognized DRP-categories ‘compliance’, ‘monitoring’, and ‘education or information’ increased, while ‘drug selection’, ‘over/under dose’, and ‘toxicity/adverse drug event’ decreased. The category ‘undertreated’ decreased in Denmark, but increased in the Netherlands. In Denmark, referrals to other healthcare providers dropped from 44.8% to 21.4%.

The mentalizing education programme shows promise to support pharmacy staff in recognizing and addressing DRPs, possibly through improved patient-centered communication.

•Pharmacy staff can play an important role in recognizing patients' drug-related problems (DRPs).•Mentalizing is a promising concept that could potentially contribute to improve patient-centered communication.•Enhanced mentalizing capacities may result in better recognition of DRPs at the pharmacy counter.•Enhanced mentalizing capacities could support pharmacy staff to solve more DRPs themselves.

Pharmacy staff can play an important role in recognizing patients' drug-related problems (DRPs).

Mentalizing is a promising concept that could potentially contribute to improve patient-centered communication.

Enhanced mentalizing capacities may result in better recognition of DRPs at the pharmacy counter.

Enhanced mentalizing capacities could support pharmacy staff to solve more DRPs themselves.