***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE to document the effectiveness of an educational intervention in improving knowledge of and practice in dispensing  emergency contraception ( EC ) among drugstore personnel in Thail and . METHODS Sixty of 120 drugstores in Hat Yai , a city in Southern Thail and , were r and omly selected , and half of them were r and omly assigned to participate in an  educational program . Well-trained " secret " shoppers went into each store before the intervention and at 1 and 3 months after the program to assess the knowledge of and practice in dispensing EC among the drugstore personnel . RESULTS Dispensing practice s at baseline were poor to fair and knowledge was fair in both groups . Sellers in the intervention group improved significantly in choice of drug , advice provided , and knowledge of the time limit for initiating EC , but those in the control group did not . However , proper history taking on the time of intercourse and menstrual cycle was poor in both groups at all study periods . CONCLUSION All drugstore personnel should be educated on the importance of history taking and on the time limit for initiating EC Objectives To compare health-related and cost-related outcomes of consultations for symptoms suggestive of minor ailments in emergency departments ( EDs ) , general practice s and community pharmacies . Design Observational study ; prospect i ve cohort design . Setting EDs ( n=2 ) , general practice s ( n=6 ) and community pharmacies ( n=10 ) in a mix of rural/urban and deprived/affluent areas across North East Scotl and and East Anglia . Participants Adults ( ≥18 years ) presenting between 09:00 and 18:00 ( Monday – Friday ) in general practice s and 09:00–18:00 ( Monday – Saturday ) in pharmacies and EDs with ≥1 of the following : musculoskeletal pain ; eye discomfort ; gastrointestinal disturbance ; or upper respiratory tract-related symptoms . Interventions Participants completed three question naires : baseline ( prior to index consultation ) ; satisfaction with index consultation and follow-up ( 2 weeks after index consultation ) . Main outcome measures Symptom resolution , quality of life , costs , satisfaction and influences on care-seeking behaviour . Results 377 patients participated , recruited from EDs ( 81 ) , general practice s ( 162 ) and community pharmacies ( 134 ) . The 2-week response rate was 70 % ( 264/377 ) . Symptom resolution was similar across all three setting s : ED ( 37.3 % ) , general practice ( 35.7 % ) and pharmacy ( 44.3 % ) . Mean overall costs per consultation were significantly lower for pharmacy ( £ 29.30 ( 95 % CI £ 21.60 to £ 37.00 ) ) compared with general practice ( £ 82.34 ( 95 % CI £ 63.10 to £ 101.58 ) ) and ED ( £ 147.09 ( 95 % CI £ 125.32 to £ 168.85 ) ) . Satisfaction varied across setting s and by measure used . Compared with pharmacy and general practice use , ED use was significantly ( p<0.001 ) associated with first episode and short duration of symptom(s ) , as well as higher levels of perceived seriousness and urgency for seeking care . Convenience of location was the most common reason for choice of consultation setting . Conclusions These results suggest similar health-related outcomes and substantially lower costs with pharmacy consultations for minor ailments . Effective strategies are now needed to shift dem and for minor ailment management away from EDs and general practice s to the community pharmacy setting Background The Pharmaceutical Society of Australia have developed " guidance " for the supply of several medicines available without prescription to the general public . Limited research has been published assessing the effect of these guidelines on the provision of medication within the practice of pharmacy . Objective To assess appropriate supply of non-prescription antifungal medications for the treatment of vaginal thrush in community pharmacies , with and without a guideline . A secondary aim was to describe the assessment and counseling provided to patients when requesting this medication . Methods A r and omized controlled trial was undertaken whereby two simulated patients conducted visits to 100 r and omly selected community pharmacies in a metropolitan region . A product-based request for fluconazole ( an oral antifungal that has a guideline was compared to a product-based request for clotrimazole ( a topical antifungal without a guideline ) . The same patient details were used for both requests . Outcome measures of the visits were the appropriateness of supply and referral to a medical practitioner . Results Overall 16 % ( n=16 ) of visits result ed in an appropriate outcome ; 10 % ( n=5 ) of fluconozaole requests compared with 22 % ( n=11 ) of clotrimazole requests ( chi-square=2.68 , p=0.10 ) . There was a difference in the type of assessment performed by pharmacy staff between visits for fluconazole and clotrimazole . A request for clotrimazole result ed in a significant increase in frequency in regards to assessment of the reason for the request ( chi-square=8.57 , p=0.003 ) , symptom location ( chi-square=8.27 , p=0.004 ) , and prior history ( chi-square=5.09 , p=0.02 ) . Conclusions Overall practice was poor , with the majority of pharmacies inappropriately supplying antifungal medication . New strategies are required to improve current practice of community pharmacies for provision of non-prescription antifungals in the treatment of vaginal thrush Background : The reclassification of prescription only medicines to pharmacy and general sales list medicines ( also known as non-prescription medicines ) provides the public with greater access to medicines that they can purchase for self-care . There is evidence that non-prescription medicines may be associated with inappropriate supply . This study investigated factors predicting evidence -based ( guideline compliant ) supply or non-supply of non-prescription medicines . Method : Secondary analysis of results from a r and omised controlled trial of educational interventions to promote the evidence based supply of non-prescription medicines .  Ten actors made simulated patient ( customer ) visits to 60 community pharmacies using seven scenarios reflecting different types of presentations . The dependent variable was appropriate ( guideline compliant ) supply of antifungal medication for treatment of vaginal c and idiasis . Results : No significant association was shown between guideline compliant behaviour and pharmacy type or location , or with the actor making the visit . The likelihood of guideline compliant outcome was significantly greater with symptom presentations than with condition or product presentations ( p<0.001 ) . The likelihood of a guideline compliant outcome increased ( a ) as more information was exchanged ( p<0.001 ) , ( b ) with the use of WWHAM ( a mnemonic frequently used by medicine counter assistants during consultations for non-prescription medicines ) ( p<0.001 ) ; ( c ) when specific WWHAM questions were used ( including “ description of symptoms ” ( p<0.001 ) and “ whether other medication was currently being used ” ( p<0.001 ) ; and ( d ) in consultations involving solely pharmacists compared with those involving only medicine counter assistants ( p = 0.017 ) . After adjustment for presentation type , a significant association persisted between appropriate outcome and consultations with WWHAM scores of 2 and ⩾3 , respectively . Conclusions : The nature and extent of information exchange between pharmacy staff and customers has a strong influence on the guideline compliant supply of non-prescription medicines . Future interventions to promote the safe and effective use of non-prescription medicines should address the apparent deficit in communication between pharmacy staff in general , and medicine counter assistants in particular , which may reflect both pharmacy staff skills and customer expectations Many minor ailments are treated in Germany by self-medication . Most drugs dispensed by pharmacy staff are those for the common cold , general pain and gastrointestinal disorders . Whilst pharmacists express their need for further training in counseling on side effects , interactions and contraindications , they tend to receive feedback from patients to the effect that the drugs used have not worked . From July to October 2013 we carried out a prospect i ve , single-blind , quasi-r and omised controlled study on the effect of training on structured pharmaceutical advice in self-medication of the common cold ( PHARMAGRIPS Study ) . Using a controlled , interventional study design we investigated whether it is possible to improve the pharmaceutical counseling in self-medication within a short time , by using an appropriate teaching method . The counseling should be made in a systematic way and refer to evidence -based content in order to avoid incorrect advice . We enrolled 86 pharmacists and assigned them r and omly into the study protocol . Of those , 56 completed the study as planned and were analysed . In this study , we review ed the structure of the average pharmaceutical consultation and added evidence -based content from the Cochrane Review s on common cold . We then integrated this structured consultation in a method ical modem training program consisting of e-learning and live classes which we evaluated scientifically . For this purpose , we conducted telephone interviews with the participating pharmacists by using st and ardized case report forms . The case report forms contained the questions that the participants were supposed to ask . For every question asked , the participant received a certain amount of points , 18 in total . The training was stated to be successful at the primary endpoint when an improvement of at least 3.5 out of 18 points was achieved on average . The secondary endpoints were related to various aspects of the interview process ( medical history , limits of self-medication , evidence -based drug selection and integration of customer input in the consultation interaction ) . The training group improved in the primary endpoint by an average of 5.93 points ( p < 0.001 ) and compared to the control group significantly in all secondary endpoints , with one participant managing to achieve the full score . The participants recognized the importance and practical relevance of the exercise in a short time and were able to implement even integrate complex content in their consultations and to give the customer appropriate advice CONTEXT Medicine counter assistants ( MCAs ) supply the majority of non-prescription medicines ( NPMs ) to consumers . Suboptimal communication during consultations between consumers and MCAs has been identified as a major cause of inappropriate supply . Evidence from medical consultations suggests that training in specified communication skills can change professional behaviour . METHODS A feasibility study was conducted to evaluate the effect of theory-based communication skills training for MCAs .  Thirty MCAs were recruited from 21 community pharmacies in Grampian , Scotl and . The intervention comprised 2 4-hour training sessions , held 1 month apart . The sessions were informed by results from previous studies and the Calgary-Cambridge evidence -based model of communication skills training . Strategies for guiding individuals through change were adopted from cognitive behavioural therapy techniques . The theory of planned behaviour was used to assess potential pathways to behaviour change . Recorded data were collected during covert visits to the pharmacies by simulated patients at baseline and 1 month after each training session . Communication performance was measured as the number and type of questions asked . RESULTS Compared with baseline measures , the total number of questions asked increased in the intervention group at both time-points . No change was shown in the control group between baseline and follow-up 1 , and a decrease was shown in the total number of questions from follow-up 1 to 2 . The intervention appeared to have greater effect on consultations involving advice , compared with those concerning product requests . DISCUSSION Communication performance improved following training . Increased information exchange is associated with guideline -compliant supply of NPMs . A substantive r and omised , controlled trial is now planned to assess the intervention Background : The importance of theory in underpinning interventions to promote effective professional practice is gaining recognition . The Medical Research Council framework for complex interventions has assisted in promoting awareness and adoption of theory into study design . Human error theory has previously been used by high risk industries but its relevance to healthcare setting s and patient safety requires further investigation . This study used this theory as a framework to explore non-prescription medicine supply from community pharmacies . The relevance to other healthcare setting s and behaviours is discussed . Method : A 25 % r and om sample was made of 364 observed consultations for non-prescription medicines . Each of the 91 consultations was assessed by two groups : a consensus group ( stage 1 ) to identify common problems with the consultation process , and an expert group ( stages 2 and 3 ) to apply human error theory to these consultations . Paired assessors ( most of whom were pharmacists ) categorised the perceived problems occurring in each consultation ( stage 1 ) . During stage 2 paired assessors from an expert group ( comprising patient safety experts , community pharmacists and psychologists ) considered whether each consultation was compliant with professional guidelines for the supply of pharmacy medicines . Each non-compliant consultation identified during stage 2 was then categorised as a slip/lapse , mistake , or violation using human error theory ( stage 3 ) . Results : During stage 1 most consultations ( n = 75 , 83 % ) were deemed deficient in information exchange . At stage 2 , paired assessors varied in attributing non-compliance to specific error types . Where agreement was achieved , the error type most often selected was “ violation ” ( n = 27 , 51.9 % , stage 3 ) . Consultations involving product requests were less likely to be guideline compliant than symptom presentations ( OR 0.30 , 95 % CI 0.10 to 0.95 , p = 0.05 ) . Conclusions : The large proportion of consultations classified as violations suggests that either pharmacy staff are unaware of professional guidelines and thus do not follow them ( therefore these acts would not be violations ) , or that they knowingly violate the guidelines due to reasons that need further research . The methods presented here could be used in other healthcare setting s to explore healthcare professional behaviour and to develop strategies to promote patient safety and effective professional practice Objective In a prospect i ve two-phase intervention study we evaluated 
    Output:
    
Conclusion : Empirical evaluation of interventions using active learning techniques such as face‐to‐face training with role‐play  can improve some communication skills .
This review identified interventions targeting pharmacy personnel .