A two‐stage audit of community pharmacists' service in response to symptoms was carried out using a previously piloted method. Pharmacists from up to 46 pharmacies completed questionnaires indicating the advice they thought should be given in each of 12 scenarios that could present to community pharmacies. The six scenarios with the highest consensus response were later enacted in the same pharmacies by researchers. Three were used in the first stage and three in the second. Meetings were held between the stages to discuss the results and suggest ways of improving them. The consensus advice, determined by the questionnaire responses, was given on only 27 per cent of all visits — 18 per cent in the first stage and 35 per cent in the second. This was mainly due to non‐drug advice being omitted. “Appropriate” products were recommended in 90 per cent of first stage visits but only 74 per cent of second stage visits. “Acceptable” advice was provided in 75 per cent of all visits, with little difference between the two stages. Questioning of the researchers was “good” in 35 per cent of first stage visits and 43 per cent of second stage visits. Inadequate questioning was significantly related to inappropriate advice being given. Inappropriate advice was given on 25 per cent of all visits, with equal frequency by both pharmacists and assistants. Participating pharmacists identified many problems that could contribute to a less than ideal service but most were outside their control, such as television advertising of products and customer expectations. The use of protocols, implementation of staff training and the audit were considered to have had a positive effect on the response to symptoms service. Most participants considered that the method used was acceptable and suggested a similar method should be used on a regular basis to mo
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