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2000
Volume 5, Issue 1
  • ISSN: 0250-6882
  • E-ISSN: 0250-6882

Abstract

Background

Dispensing practice is the fundamental component of the rational use of drugs. Inappropriate dispensing of drugs can lead to Adverse drug reaction (ADR), Drug interaction (DI), therapeutic failure, and increased cost of treatment. In case of antibiotic misuse, it can lead to developing an extra burden of antibiotic resistance.

Objective

The objective of this study was to determine the antibiotic dispensing practice and the impact of intervention among medicine retailers of Butwal and Bhairahawa cities of Nepal.

Methods

An interventional simulated patients survey study was conducted in two cities of Nepal from 2016-2018. A scenario of fictitious cases of common cold and running nose was simulated by two trained pharmacists in two different sites. Prior to the survey, the researcher visited selected retailers to obtain consent and demography details. About two weeks after obtaining consent, simulated patients visited the retailers. The information given by the community pharmacist was memorized and recorded in data collection form after leaving the community pharmacy. The intervention study was carried out 30 days after the simulated study survey. The educational intervention was given to the test group . the community medicine retailer of Butwal. The researchers also provided a booklet to the test groups. Post-intervention simulated patient survey was conducted after 3 days of the training period. Data were entered into Microsoft Excel and SPSS for analysis.

Results

All together 64 community pharmacies were included in this study involving 32 medicine retailers from each city of Butwal and Bhairahawa. The total drugs dispensed by medicine retailers were 146 and 127 drugs in Butwal and Bhairahawa, respectively in the before-intervention studies. Similarly, about 122 and 152 drugs were dispensed by medicine retailers in Butwal and Bhairahawa after intervention studies. The average numbers of medicines dispensed by medicine retailers were 4.56±1.66 and 3.96±1.92 before intervention in the Butwal and Bhairahawa study sites. The average numbers of medicines dispensed by medicine retailers were 3.78±1.06 and 4.78±1.73 after intervention in the study sites of Butwal and Bhairahawa. None of the medicine retailers talked about either the brand or generic name and strength of antibiotic medicine to the simulated patient before and after intervention in both study sites. Similarly, medicine retailers informed about the frequency of dosage of antibiotic medicine to simulated patients before and after interventions in Butwal and Bhairahawa cities. However, there was no statistical significance (P=0.388) observed in Butwal City, whereas in Bhairahawa City, statistical significance (P=0.006) was observed.

Conclusion

Antibiotic dispensing without a prescription is routine. Insufficient medicine information was given to the simulated patient by the medicine retailer. Hence, we suggest meaningful implementation of policy and regular inspection to improve the situation.

This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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2024-12-14
2025-01-19
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References

  1. WHOPromoting rational use of medicines: core component.WHO Policy Perspectives on Medicines200216
    [Google Scholar]
  2. WHOWHO Global strategy for containment of antimicrobial resistance.Switzerland2001Available from: https://apps.who.int/iris/handle/10665/66860
    [Google Scholar]
  3. SururAS. GetachewE. TeressaE. HailemeskelB. GetawNS. ErkuD. Self-reported and actural involvement of community pharmacist in patient counselling: A cross sectional and simulated patient study in Gondar, Ethiopia.Pharm. Pract.2017150189010.18549/PharmPract.2017.01.89028503225
    [Google Scholar]
  4. ZawahirS. LekamwasamS. AslaniP. Antibiotic dispensing practice in community pharmacies: A simulated client study.Res. Social Adm. Pharm.201915558459010.1016/j.sapharm.2018.07.01930093309
    [Google Scholar]
  5. KafleK.K. KarkeeS.B. Consumption of antibiotics and other medicines.Pharmaceutical Horizon of Nepal (PHON)2007
    [Google Scholar]
  6. Government of NepalDepartment of drug administration.Drug ActAvailable from:http://dda.gov.np/content/drugs-act-2035
    [Google Scholar]
  7. VolpatoD.E. SouzaB.V. Dalla RosaL.G. MeloL.H. DaudtC.A.S. DeboniL. Use of antibiotics without medical prescription.Braz. J. Infect. Dis.20059428829110.1590/S1413‑8670200500040000416270120
    [Google Scholar]
  8. Bin AbdulhakA.A. Al TannirM.A. AlmansorM.A. AlmohayaM.S. OnaziA.S. MareiM.A. AldossaryO.F. ObeidatS.A. ObeidatM.A. RiazM.S. TleyjehI.M. Non prescribed sale of antibiotics in Riyadh, Saudi Arabia: A cross sectional study.BMC Public Health201111153810.1186/1471‑2458‑11‑53821736711
    [Google Scholar]
  9. ShetA. SundaresanS. ForsbergB.C. Pharmacy-based dispensing of antimicrobial agents without prescription in India: appropriateness and cost burden in the private sector.Antimicrob. Resist. Infect. Control2015415510.1186/s13756‑015‑0098‑826693005
    [Google Scholar]
  10. HaddadinRN. AlsousM. WazaifyM. TahainehL. Evaluation of antibiotic dispensing in community pharmacies in Jordan: A cross sectional study.PLoS One2019144021611510.1371/journal.pone.0216115
    [Google Scholar]
  11. WHOThe world health report 2007 : A safer future : global public health security in the 21st century.2007Available from:https://www.who.int/publications/i/item/9789241563444
  12. WHORational use of medicines: progress in implementing the WHO medicines strategy.World Health Organization2006Available from:https://apps.who.int/gb/ebwha/pdf_files/EB118/B118_6-en.pdf
    [Google Scholar]
  13. NgaD.T.T. ChucN.T.K. HoaN.P. HoaN.Q. NguyenN.T.T. LoanH.T. ToanT.K. PhucH.D. HorbyP. Van YenN. Van KinhN. WertheimH.F.L. Antibiotic sales in rural and urban pharmacies in northern Vietnam: An observational study.BMC Pharmacol. Toxicol.2014151610.1186/2050‑6511‑15‑624555709
    [Google Scholar]
  14. JhaN. ShresthaS. ShankarPR. KhadkaA. AnsariM. SapkotaB. Antibiotic dispensing practices at community pharmacies in Kathmandu and Lalitpur Districts of Nepal.Indian Journal of Pharmacy Practice.202013433534010.5530/ijopp.13.4.57
    [Google Scholar]
  15. WachterD.A. JoshiM.P. RimalB. Antibiotic dispensing by drug retailers in Kathmandu, Nepal.Trop. Med. Int. Health199941178278810.1046/j.1365‑3156.1999.00476.x10588773
    [Google Scholar]
  16. Al-MohamadiA. BadrA. Bin MahfouzL. SamargandiD. Al AhdalA. Dispensing medications without prescription at Saudi community pharmacy: Extent and perception.Saudi Pharm. J.2013211131810.1016/j.jsps.2011.11.00323960815
    [Google Scholar]
  17. ErkuDA. MekuriaAB. SururAS. GebresillassieBM. Extent of dispensing prescription only medications without a prescription in community drug retail outlet in Addis Ababa, Ethiopia: A simulated patient study.Drug Healthc. Patient Saf.20168657010.2147/DHPS.S10694827471409
    [Google Scholar]
  18. DamisieG. HambisaS. YimamMd. Over the counter sale of antibiotics at drug stores found in Mizan Aman town, Southwest Ethiopia: A cross sectional simulated client visit study.Hindawi Journal of Pharmaceutics.201935106590610.1155/2019/3510659
    [Google Scholar]
  19. HorumpendeP.G. SondaT.B. van ZwetselaarM. AntonyM.L. TenuF.F. MwanzivaC.E. ShaoE.R. MshanaS.E. MmbagaB.T. ChilongolaJ.O. Prescription and non-prescription antibiotic dispensing practices in part I and part II pharmacies in Moshi Municipality, Kilimanjaro Region in Tanzania: A simulated clients approach.PLoS One20181311e020746510.1371/journal.pone.020746530462700
    [Google Scholar]
  20. ChangJ. YeD. LvB. JiangM. ZhuS. YanK. TianY. FangY. Sale of antibiotics without a prescription at community pharmacies in urban China: A multicentre cross-sectional survey.J. Antimicrob. Chemother.2017724dkw51910.1093/jac/dkw51928062684
    [Google Scholar]
  21. IbrahimMdI. PalaianS. Al-sulaitiF. El-shamiS. Evaluating community pharmacy practice in Qatar using simulated patient method: Acute gastroenteritis management.Pharm pract.201614480010.18549/PharmPract.2016.04.800
    [Google Scholar]
  22. ZawahirS. LekamwasamS. AslaniP. Community pharmacy staff’s response to symptoms of common infections: A pseudo-patient study.Antimicrob. Resist. Infect. Control2019816010.1186/s13756‑019‑0510‑x30976387
    [Google Scholar]
  23. Zapata-CachafeiroM. Piñeiro-LamasM. GuinovartM.C. López-VázquezP. Vázquez-LagoJ.M. FigueirasA. Magnitude and determinants of antibiotic dispensing without prescription in Spain: A simulated patient study.J. Antimicrob. Chemother.201974251151410.1093/jac/dky44030395222
    [Google Scholar]
  24. ChangJ. XuS. ZhuS. LiZ. YuJ. ZhangY. ZuJ. FangY. Ross-DegnanD. Assessment of non-prescription antibiotic dispensing at community pharmacies in China with simulated clients: A mixed cross-sectional and longitudinal study.Lancet Infect. Dis.201919121345135410.1016/S1473‑3099(19)30324‑X31588042
    [Google Scholar]
  25. AhmadT. KhanF.U. AliS. RahmanA.U. Ali KhanS. Assessment of without prescription antibiotic dispensing at community pharmacies in Hazara Division, Pakistan: A simulated client’s study.PLoS One2022172e026375610.1371/journal.pone.026375635176043
    [Google Scholar]
  26. TamunoI. FadareJ.O. Drug prescription pattern in a Nigerian tertiary hospital.Trop. J. Pharm. Res.201211114615210.4314/tjpr.v11i1.19
    [Google Scholar]
  27. SisayM AbdelaJ KanoZ ArayaM ChemdiM A drug prescribing and dispensing practices in tertiary care hospital of eastern Ehtiopia: Evaluation with world health organization core prescribing and patient care indicators.J. Clin. Exp. Pharmacol.201773010810.4172/2161‑1459.1000238
    [Google Scholar]
  28. PalikheN. Prescribing pattern of antibiotics in paediatric hospital of Kathmandu valley.Kathmandu Univ. Med. J.20042161219780281
    [Google Scholar]
  29. WHOMedication safety in polypharmacy Technical Report.Geneva, SwitzerlandWHO Document Production Services20191163Available from: https://apps.who.int/iris/handle/10665/325454
    [Google Scholar]
  30. AdepuR. Patient counselling. A textbook of clinical pharmacy practice, essential concepts and skills.2nd ed ParthasarathiG. HansenK.N. NahataM.C. Universities Press6067
    [Google Scholar]
  31. GhasemiP. KavarianS. Omnibus budget reconciliation act of 1990 and 1993.Pro Pharma Pharmaceutical Consultants2015
    [Google Scholar]
  32. HussainA. IbrahimM.I. MalikM. Dispensing practices at community pharmacies: A cross sectional study from Pakistan.Value Health2013163A21010.1016/j.jval.2013.03.1062
    [Google Scholar]
  33. AlfadiAA AlrasheedyAA AlhassunMS Evaluation of medication counselling practice at community pharmacies in Qassim region, Saudi Arabia.Saudi Pharm. J.20182625826210.1016/j.jsps.2017.12.00230166925
    [Google Scholar]
  34. AlaqeelS. AbanmyN.O. Counselling practices in community pharmacies in Riyadh, Saudi Arabia: A cross-sectional study.BMC Health Serv. Res.201515155710.1186/s12913‑015‑1220‑626669857
    [Google Scholar]
  35. NigussieW.D. Patient counselling at dispensing of medicines in health care facility outpatient pharmacies of Bahir Dar city, Northwest Ethiopia.Science Journal of Public Health.201422126134
    [Google Scholar]
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  • Article Type:
    Research Article
Keyword(s): Antibiotic; Community Pharmacy; Dispensing; Nepal; Practice; Simulation
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