# What is the pharmacist-patient culture in Spain?



## AllHeart (Nov 22, 2013)

I'm hoping someone can advise me on the pharmacist-patient culture in Spain. In Canada, I had a very close relationship with my pharmacists and I work very hard to do my homework to be a responsible patient. At my local pharmacy, I've had a few incidents where the pharmacists won't answer my questions and insist that I speak to my doctors with my questions. Some of the pharmacists are okay, but others aren't. Today I had a blow-out with one of the pharmacists and I'm really rattled about this.

I'm having a lot of trouble with new medications that are being prescribed for my neuromuscular symptoms, and I'm incredibly frustrated that I have no source of information on medications other than my medical doctors and their nurses. After today's blow-out with the pharmacist, it occurs to me that it may be the culture in Spain that a pharmacist is only to be dispensing medication and not providing any advice, unless the medications are non-prescription. 

So is the mute pharmacist the culture in Spain, or does this vary between pharmacies? It also occurs to me that there may even be laws here in Spain dictating what the pharmacists can and can't say. 

Please.... :help:


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## snikpoh (Nov 19, 2007)

I would agree if you were talking about chemists in the UK.

In Spain, it'a certainly my experience that they offer a lot of advice and help. Not that we, as a family, get ill very often but we have gone to the farmacia in preference to the doctors and found them to be very, very helpful.


If it's something serious (as in your case with neuromuscular symptoms) then I can see why some pharmacists are being cautious. (just my opinion)


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## xabiaxica (Jun 23, 2009)

I agree with snikpoh - the pharmacists here are on the whole very helpful & caring & will give advice & recommendations, & check whether medications 'clash'

I know two of them here quite well & use them in preference to the other dozen in the town

one of them, a few months after my husband died, dragged me into his 'back room' & insisted upon taking my blood pressure because he was worried about me - after all - with my dad who lived with us & my husband both passing away within a few months of each other, leaving me alone with my daughters, I had to be stressed, right? 


blood pressure was fine, btw 


Allheart, you either found an unfriendly pharmacist or as snikpoh says, he is being extra-careful taking into consideration your condition


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## Calas felices (Nov 29, 2007)

You also have to be careful as a number of pharmacies have people walking around in white coats who are merely salespeople and have little or no medical background. When you get through to to the actual pharmacist they can be very helpful but often their advice is based on what they are reading off their computer screen. If they are cautious about giving advice it's probable they don't know.


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## kalohi (May 6, 2012)

I also think that pharmacists here are usually very helpful, but then again it depends on the questions you are asking them. Of course they'll always give information about purely pharmaceutical problems like drug interactions or how to take a medication. Also, if you ask for something to help with a cough, or athlete's foot, or some other minor problem, they'll pull out a medication for you and save you a trip to the doctor's. But as others have said, as soon as you start asking about more unusual medical problems I've found they immediately say to see your doctor. Neuromuscular symptoms probably fall into that category. 

As an aside, the same goes for buying prescription medication. I've found they'll usually sell 'normal' prescription medications without the prescription, but not more unusual medications. I take two 'normal' prescription medication and one unusual one, and they won't sell me that unusual one no matter where I go without that prescription. However, I can pick up the other two prescription free anywhere.


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## xabiaxica (Jun 23, 2009)

kalohi said:


> I also think that pharmacists here are usually very helpful, but then again it depends on the questions you are asking them. Of course they'll always give information about purely pharmaceutical problems like drug interactions or how to take a medication. Also, if you ask for something to help with a cough, or athlete's foot, or some other minor problem, they'll pull out a medication for you and save you a trip to the doctor's. But as others have said, as soon as you start asking about more unusual medical problems I've found they immediately say to see your doctor. Neuromuscular symptoms probably fall into that category.
> 
> As an aside, the same goes for buying prescription medication. I've found they'll usually sell 'normal' prescription medications without the prescription, but not more unusual medications. I take two 'normal' prescription medication and one unusual one, and they won't sell me that unusual one no matter where I go without that prescription. However, I can pick up the other two prescription free anywhere.


that too

I take a 'prescription only' pain relief medication - my prescription is for 3 a day, they come in packs of 20 & I get two packs a fortnight - do the maths....

also, I can 'safely' take double my usual dose & will sometimes take an extra tablet or two, so can run out

any farmacia will sell me a pack of the tablets, whether they know me or not....


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## fergie (Oct 4, 2010)

I have found pharmacists in my town very helpful for my prescription medication, they have even helped with suggestions and the occasional ordering of prescriptions for my chronically sick little dog. Pharmacists are highly trained professionals, but are not there to prescribe especially for certain illness. My pharmacy, I prefer to use does not know I am a medically trained person, I hold my 'hands up' and realise that they know more about each specific drug, and it's side effects than I do, especially as I am retired,and no longer practicing, and a lot of things have changed.
With research happening all the time,and newer drugs on the market, and older ones perhaps proving to be un-safe, or causing longer term problems, the pharmacists sometimes have to refer clients back to the doctor, which is the correct thing to do, they have their reputation and registration to protect.
Googling mediactions is not a safe thing to do either, it can put the fear of 'God' in some people.


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## snikpoh (Nov 19, 2007)

Rightly or wrongly, if you have a good rapport with your pharmacist, they will help in other ways too.

I am extremely allergic to nuts and insect stings. Consequently I have to carry an epipen with me at all times (adrenaline). These generally are only available with a prescription and need replacing every couple of years (as they go out of date). My pharamacist sells me the pen whenever I need it and without a prescription.


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## AllHeart (Nov 22, 2013)

Thank you all for your encouragement and information. I'm so happy to know that the pharmacists here can help me with my questions. Yes, it could well be that those who don't answer my questions are uncomfortable with my slew of illnesses and medications.

So I've decided to switch pharmacies. In the five months I've been going to my current pharmacy, I've dealt with five pharmacists, so it's hard to develop a close relationship with them. So I'll be looking for a pharmacy that has less pharmacists so I can develop a closer relationship. I'll also look for a pharmacist who is comfortable in answering my questions, and just say up front that I want to be able to ask questions.

...I just got off the phone with my palliative care doc, and she has changed the medication I'm currently concerned about. She has me on 0.75 mg daily of rivotril as a muscle relaxant, and I just can't function on it because I'm sooooo tired that I'm cross eyed. That was my question to my pharmacist yesterday - if there are other antispasmotic medications that won't make me so tired, which he refused to answer. Today she changed me to Baclofeno. 

Thanks again for all your guidance. You guys rock!


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## kalohi (May 6, 2012)

AllHeart said:


> ...I just got off the phone with my palliative care doc, and she has changed the medication I'm currently concerned about. She has me on 0.75 mg daily of rivotril as a muscle relaxant, and I just can't function on it because I'm sooooo tired that I'm cross eyed. That was my question to my pharmacist yesterday - if there are other antispasmotic medications that won't make me so tired, which he refused to answer. Today she changed me to Baclofeno.


That's just the kind of question that I wouldn't expect a pharmacist here to answer. There must be many antispasmotic medications and only your doctor could know your medical history well enough to decide which one to recommend. A pharmacist would never dare suggest a change to a different medication. 

At any rate you should feel comfortable with your pharmacy. There seems to be one on nearly every corner here in Spain so I'm sure you have plenty to choose from. Be sure you talk to a pharmacist and not to an assistant. They very often wear a name tag and it should say if they're a pharmacist or not.


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## AllHeart (Nov 22, 2013)

kalohi said:


> That's just the kind of question that I wouldn't expect a pharmacist here to answer. There must be many antispasmotic medications and only your doctor could know your medical history well enough to decide which one to recommend. A pharmacist would never dare suggest a change to a different medication.


It was just a general question, and would have been answered by my Canadian pharmacists. I wasn't asking for a specific drug, just asking if there are other muscle relaxants that don't cause so much fatigue. That's why I come to ask you here, knowing that I'm in a different country and a different culture. So now I know that's too much to ask. 

I'm going to the same pharmacy today to pick up my new drug, and I'll talk with them about this problem, and see if we can iron things out. They have all been really good to me, and I think it's a matter of knowing what to ask and what not to ask. So perhaps the problem is more me adapting to this culture. They even gave me a Christmas present of a 750 mL bottle of Interapothek aloe vera bath gel.


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## Pesky Wesky (May 10, 2009)

Some health centres/ doctors have a system whereby you can email them a question or just phone them directly. You might want to make an appointment with your doctor to talk about this possibility.


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## AllHeart (Nov 22, 2013)

Pesky Wesky said:


> Some health centres/ doctors have a system whereby you can email them a question or just phone them directly. You might want to make an appointment with your doctor to talk about this possibility.


 Yes, my palliative care team (docs and nurses) are available by phone. But are you saying that my family doc might have this system?


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## Pesky Wesky (May 10, 2009)

AllHeart said:


> Yes, my palliative care team (docs and nurses) are available by phone. But are you saying that my family doc might have this system?


Yes!
I think it probably depends on the area/ doctor/ health system/ illness/ and if you've got a blue car or a pair of roller skates, but I do know people who have this kind of contact with their doctors here in my town


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## AllHeart (Nov 22, 2013)

Pesky Wesky said:


> Yes!
> I think it probably depends on the area/ doctor/ health system/ illness/ and if you've got a blue car or a pair of roller skates, but I do know people who have this kind of contact with their doctors here in my town


 What great news. I have an appointment with him tomorrow to discuss other things. So I'll ask about this too. Thank you! 

P.S. I sold my roller skates and red car in Canada. But I'll brings pics as proof, so that I can qualify.


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## AllHeart (Nov 22, 2013)

Well, it's all sorted out about the pharmacy... I've decided to go with a new pharmacy where there is only one pharmacist. I really feel much more comfortable with this, so we can build a relationship. We've met three times already, and he's very knowledgeable and helpful, and extremely personable. Today I met his son, who works with him, which is nice to get a family feeling to the pharmacy.  

The new medication, Baclofeno, is working really well too, without making me as tired. 

Also, I found out that they do indeed have a phone number for my health clinic for medical questions. So thanks, Pesky Wesky, for telling me about that.

I also found out through this phone line that if I'm too sick to get to the clinic, my family doctor will make a house visit. Wow! Did I ever say that I love Spain?


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