Analytical Evaluation of Dispensing Quality and Patient Outcomes at Community Pharmacies in Oyo State Using Simulated Patient Method

The simulated patient method offers an objective and validated approach to evaluating community pharmacy dispensing quality, eliminating social desirability bias that affects direct observation. This study analytically evaluated dispensing quality and simulated counselling provision at community pharmacies in Ibadan, Oyo State, using a standardised simulated patient methodology. A cross-sectional analytical study employing trained simulated patients was conducted at 60 purposively sampled community pharmacies across three pharmacy density zones (high, medium, low) in Ibadan. Simulated patient scenarios covered prescription presentation (antihypertensives), symptom-based enquiry (cough management), and non-prescription analgesic purchase. Simulated patients recorded responses using standardised checklists covering eight quality indicators. ANOVA and chi-square analysis compared quality scores across density zones and pharmacist-to-technician staffing categories. Results showed mean overall dispensing quality scores of 58.4 percent across all scenarios, with the lowest scores in symptom assessment adequacy (44.7 percent) and referral decision-making (39.8 percent). High-density pharmacy zones showed significantly lower quality scores than low-density zones (p < 0.01), consistent with workload-related quality compromise. Pharmacist-staffed dispensing encounters showed significantly higher quality scores than technician-only encounters (p < 0.001). Analgesic purchase scenarios generated the lowest referral rates despite simulated warning symptoms. The study provides the first simulated patient-based pharmacy quality analysis from Oyo State, identifying workload and staffing as the primary quality determinants. Keywords: simulated patient method, dispensing quality, community pharmacy, Oyo State, pharmaceutical care quality