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Qualification, knowledge and experience of dispensers working at community pharmacies in Pakistan

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      Abstract

      Pharmacies are managed by a variety of dispensers in terms of qualification, knowledge and experience in Pakistan.

      Objective

      The study aimed to document the state of knowledge, experience and qualification of dispensers working at community pharmacies in Pakistan.

      Methods

      A comparative cross sectional study was conducted at a randomly selected sample of 371 pharmacies in the three cities of Pakistan. A structured questionnaire for data collection was developed and finalized by focused group discussions and pilot testing. The data was coded, entered and analyzed by using SPSS Version 16. Kruskal-Wallis and Mann-Whitney tests (p≤0.05) were performed to find out differences.

      Results

      Out of total sample of 371 pharmacies, 31.8 % (118) were in Islamabad, 32.4 % (120) in Peshawar and 35.8 % (133) were in Lahore. Fifty percent of the respondents had correct knowledge of range of room temperature at which medicines should be stored. Only 11.1% (41) of the respondents knew about OTC (over the counter drugs) which can be sold without prescription while 5.9 % (22) of the respondents were aware of POM (prescription only medicines) which can be only sold on a valid prescription. While 87.6% (325), 88.1% (327), 58.7% (318) and 95.7 % (355) of the respondents did not know the meaning of the dispensing abbreviations such as ‘h.s’, ‘q.d’, ‘sos’ and ‘p.r.n’. The respondents did not know correctly the status of Deltacortil® (Prednisolone), Septran® (Sulfamethoxazole) and Fansidar® (Pyrimethamine and Sulfadoxine) either as OTC or POM in 26.7% (99), 64.2% (238), and 44.5 % (165) of the cases, respectively. There was a significant difference (p≤0.05) in knowledge of dispensers regarding storage temperature, prescription terminologies and status of medicines having different level of qualification and experience.

      Conclusions

      The overall knowledge and training of dispensers working at community pharmacies is inadequate in Pakistan. However, pharmacists had relatively better knowledge regarding storage temperature, prescription terminologies and status of medicines as compared to pharmacy assistants, diploma holders and salesperson.

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      Most cited references 25

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      Pharmacies, self-medication and pharmaceutical marketing in Bombay, India.

       M Nichter,  V. Kamat (1998)
      Studies of pharmaceutical practice have called attention to the role played by pharmacists and pharmacy attendants in fostering self-medication and medicine experimentation among the public. Left undocumented is the extent to which clients passively follow the advice of pharmacy personnel or question their motive or expertise. While research has focused on pharmacists and pharmacy attendants as agents encouraging self-medication and medicine experimentation, adequate attention has not been paid to pharmacist-client interactions that are sensitive to the social, cultural, and economic context in which medicine sales and advice occur. This paper highlights the context in which pharmacy attendants engage in "prescribing medicines" to the public in Bombay, India. An ethnographic description of pharmacies and pharmaceutical-related behavior in Bombay is provided to demonstrate how reciprocal relationships between pharmacy owners, medicine wholesalers and pharmaceutical sales representatives (medreps) influence the actions of pharmacy staff. Attention is focused on the role of the medicine marketing and distribution system in fostering prescription practice, pharmacy "counter-pushing" and self-medication. In documenting the profit motives of different players located on the drug sales continuum, it is argued that the economic rationale and the symbiotic relations that exist between doctors, medreps, medicine wholesalers and retailers, need to be more closely scrutinized by those advocating "rational drug use".
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        Malaria treatment in the retail sector: Knowledge and practices of drug sellers in rural Tanzania

        Background Throughout Africa, the private retail sector has been recognised as an important source of antimalarial treatment, complementing formal health services. However, the quality of advice and treatment at private outlets is a widespread concern, especially with the introduction of artemisinin-based combination therapies (ACTs). As a result, ACTs are often deployed exclusively through public health facilities, potentially leading to poorer access among parts of the population. This research aimed at assessing the performance of the retail sector in rural Tanzania. Such information is urgently required to improve and broaden delivery channels for life-saving drugs. Methods During a comprehensive shop census in the districts of Kilombero and Ulanga, Tanzania, we interviewed 489 shopkeepers about their knowledge of malaria and malaria treatment. A complementary mystery shoppers study was conducted in 118 retail outlets in order to assess the vendors' drug selling practices. Both studies included drug stores as well as general shops. Results Shopkeepers in drug stores were able to name more malaria symptoms and were more knowledgeable about malaria treatment than their peers in general shops. In drug stores, 52% mentioned the correct child-dosage of sulphadoxine-pyrimethamine (SP) compared to only 3% in general shops. In drug stores, mystery shoppers were more likely to receive an appropriate treatment (OR = 9.6), but at an approximately seven times higher price. Overall, adults were more often sold an antimalarial than children (OR = 11.3). On the other hand, general shopkeepers were often ready to refer especially children to a higher level if they felt unable to manage the case. Conclusion The quality of malaria case-management in the retail sector is not satisfactory. Drug stores should be supported and empowered to provide correct malaria-treatment with drugs they are allowed to dispense. At the same time, the role of general shops as first contact points for malaria patients needs to be re-considered. Interventions to improve availability of ACTs in the retail sector are urgently required within the given legal framework.
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          Real world pharmacy: assessing the quality of private pharmacy practice in the Lao People's Democratic Republic.

          The private sector is a dominant actor in the provision of pharmaceuticals, particularly in developing countries. Private provision of drugs has been associated with risks regarding availability, affordability, rational use and drug quality. Ensuring an effective regulatory framework is therefore a major challenge for governments, yet the capacity of regulatory authorities is often outstripped by private sector growth. In the Lao People's Democratic Republic (Lao P.D.R.), a poor, landlocked country in South East Asia, the private provision of drugs has increased dramatically since the liberalisation of the economy in the late 1980s. This paper aims to describe the quality of the private pharmacy services in the Savannakhet province of Lao P.D.R. In order to do this, a monitoring instrument which serves to make the concept of Good Pharmacy Practice (GPP) operational was developed and applied to a sample of pharmacies. Service quality, as measured by three facility-specific indicators, showed a tendency to be lower in the most distant districts. Poor dispensing practices were manifest by a lack of information about drugs sold in 59% of cases, drugs not being labelled in 47% and different drugs being mixed in the same package in 26% of cases. The prices of four sample drugs were slightly higher in the remote districts. A 10-fold price difference for the same drug was recorded in one district. After reporting the findings, the paper discusses the possible influence of district and pharmacy variables on the quality of services, and goes on to discuss the price differences. It is concluded that further government interventions are needed in order to improve the quality of services and to focus regulatory action on a limited number of aspects, to ensure that drugs can be traced before trying to establish a comprehensive regulatory system.
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            Author and article information

            Affiliations
            Discipline of Social and Administrative Pharmacy, University Sains Malaysia . Penang (Malaysia) and Associate Professor. Hamdard Institute of Pharmaceutical Sciences Hamdard University , Islamabad (Pakistan).
            College of Pharmacy, Al Qassim University . Al Qassim, (Saudi Arabia).
            Contributors
            Discipline of Social and Administrative Pharmacy, University Sains Malaysia . Penang (Malaysia) and Associate Professor. Hamdard Institute of Pharmaceutical Sciences Hamdard University , Islamabad (Pakistan).
            College of Pharmacy, Al Qassim University . Al Qassim, (Saudi Arabia).
            Journal
            Pharm Pract (Granada)
            Pharm Pract (Granada)
            Pharm Pract
            Pharmacy Practice
            Centro de Investigaciones y Publicaciones Farmaceuticas
            1885-642X
            1886-3655
            Apr-Jun 2011
            17 June 2011
            : 9
            : 2
            : 93-100
            3969832 PhP-378
            Copyright © 2011, CIPF

            This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

            Funding
            The study was partially funded by Research & Development program of Ministry of Health, Government of Pakistan.
            Categories
            Original Research

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