How do Australian metropolitan and rural pharmacists counsel consumers with prescriptions?

Objective To investigate and compare counselling provided by community pharmacists in Australian metropolitan and rural pharmacies. Methods Mail surveys to 650 randomly selected New South Wales (NSW) community pharmacies [385 (59%) metropolitan, 265 (41%)] rural were conducted. Main outcome measure The rates of verbal and written prescription medicine information and type of information given both for new and regular medicines were determined. The rates of verbal information were also explored by assessing how likely pharmacists were to counsel based on hypothetical cases for new prescription medicines. Results A response-rate of 42% was obtained from 116/378 (31%) metropolitan and 156/262 (60%) rural pharmacies. A higher proportion of metropolitan than rural pharmacists reported providing verbal information for more than 50% of new prescriptions (P < 0.001) and for more than 50% of regular prescriptions (P < 0.001). In contrast, a higher proportion of rural than metropolitan pharmacists reported giving out Consumer Medicine Information leaflets (CMIs) for more than 50% of new prescriptions (P = 0.007). After controlling for any identified confounders, metropolitan pharmacists were 4.6 times more likely to verbally counsel on new prescriptions and 3.1 times more likely to counsel on regular prescriptions, while rural pharmacists were 2.4 times more likely to give out CMIs for new prescriptions. Information on medicine administration was provided more frequently than information on the safety aspects of medicine, with both types of information being more frequently given for new than regular prescription medicines. There was variability in responses to hypothetical cases and not all respondents were highly likely to counsel on all new prescriptions. Conclusion Metropolitan pharmacists tended to provide verbal information, while rural pharmacists tended to give out written information. The respondents prioritised counselling on medicine administration for new prescription medicines. Not all respondents, however, were highly likely to counsel on all new prescriptions.