Below are three case studies based on real customer experience at pharmacies. Please read and consider your response to the questions that follow each study.
Case study one
T is a 32-year-old single woman who feels she is sexually liberal, although she comes from a conservative African background where sex outside marriage is considered taboo.
T was visiting her pharmacy to access emergency contraception. On entering the pharmacy, T noted that it was quiet and the male staff were gathered at the back of the store talking. T approached them and asked to speak to the pharmacist.
One of the staff asked, ‘Why do you need to speak to the pharmacist?’ to which T replied, ‘I need to speak with them about a private matter.’
Although he seemed reluctant, the staff member called the female pharmacist over to the desk, who then loudly asked T, ‘What can I help you with?’
Although she felt uncomfortable answering T replied, ‘I’d like to purchase some emergency contraception.’
T then noticed that the atmosphere in the pharmacy changed. The talking had stopped and all the staff were listening to her conversation. As she noted this the pharmacist asked T, ‘Have you taken this before? When did you last have unprotected sex?’ This was asked in front of the staff and another customer who had entered the store, which made T even more uncomfortable.
T asked the pharmacist, ‘Can we discuss this privately?’ and she replied ‘OK’ in a way that T felt was both angry and dismissive of her request.
The pharmacist showed T into a private consultation room and then asked additional questions and gave instructions on how and when to use the medication. Once this was explained, the pharmacist and T went back to the counter and the pharmacist went to the medicines area to get the medication and then back to the counter to ring up T’s purchase. As her purchase was being processed the pharmacist said to T in a loud voice, ‘Just remember you need to take this for five days from when you had unprotected sex for it to work.’
T took her purchase and left the store feeling upset and humiliated at her treatment and lack of discretion on the part of the pharmacist and staff. She has decided she will not use that pharmacy again.
Questions to consider
- What lessons could be learned from T’s experience?
- Did the interaction follow guidelines?
- What training opportunities arise from this exchange?
- How could you intervene at your own pharmacy if you witnessed an exchange like this?
Case study two
A married couple, a man aged over 80 and woman aged over 60, have asked their pharmacy to include his HIV medications in the dossette box they prepare of all his medications.
They have asked the pharmacy to do this for them as the carers that come in three times a day to provide care and administer his medications have refused to administer the HIV medications unless they are included in the dossette box as it is against policy.
Despite many conversations with the pharmacy, this request has still not been met, as the conditions the pharmacy are asking for to be in place change with every conversation. The couple now believe the issue is that the request is related to HIV and not conditions or policies.
Questions to consider
- What do you think are the reasons the pharmacy is not complying with this request?
- What training needs have been identified by this example?
- How could you intervene at your own pharmacy if you were made aware of a situation such as this?
Case study three
F is a man of black African ethnicity in his early 40s. He has received treatment with the pharmacy previously having been diagnosed and treated for chlamydia and gonorrhoea. He has also within the last year received a course of PEP, although he is unsure if he finished the month-long course of treatment as he tested HIV negative 14 days into the regimen.
During previous discussions he has disclosed that he is married and also has sex with partners outside his marriage. He says he uses condoms when he remembers with partners who aren’t his wife. He doesn’t use condoms when he has sex with his wife as he says that would make her ‘suspicious’.
He is very concerned about HIV has asked to speak to the pharmacist as he wants to ask what the strongest condoms that will protect him against HIV are. Despite these concerns, F finds it very difficult to discuss HIV and says he has little knowledge about it apart from avoiding certain ‘good time’ girls.
Questions to consider
- What are the points you could discuss with F about his sexual history and beliefs?
- Do you think he is a good candidate for PrEP?
- How could you help F overcome his fear and concerns about HIV?