Assessment of Risks Related to Medicine Dispensing by Nonprofessionals in Colombia: Clinical Case Simulations

2005 ◽  
Vol 39 (3) ◽  
pp. 527-532 ◽  
Author(s):  
Claudia Vacca ◽  
José Orozco ◽  
Albert Figueras ◽  
Dolors Capellà
Keyword(s):  
Drug Use ◽  
Drug Prescription ◽  
Educational Background ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Essential Information ◽  
Rational Drug Use ◽  
Rational Drug ◽  
Public Health Institutions ◽  
Therapeutic Problem

BACKGROUND: Appropriate dispensing is one of the steps for rational drug use, so it is generally advised that the dispenser should have relevant and updated knowledge, skills, and attitudes. OBJECTIVE: To assess pharmacies and nonprofessional employees' (NEs) skills and knowledge, as well as their response to several specific case simulations in Bogotá, Colombia. METHODS: A descriptive cross-sectional study was performed on a random sample of 371 pharmacies in Bogotá. Information from each pharmacy was obtained using 2 approaches: (1) direct interview to collect data on organizational aspects of the store and characteristics of NEs, and (2) simulation (both by direct interview and by telephone) to assess dispensing responses in 6 simulated clinical cases. RESULTS: More than half of the simulated clinical situations resulted in inappropriate dispensing (direct simulations 57%; telephone simulations 55%). The proportion of correct answers to theoretical questions regarding a specific therapeutic problem during interviews was higher than the response when a simulation presented that same case and a dispensing act was expected. The educational background of the NEs included in the study points to a specific problem: two-thirds of the individuals selling medicines had completed only secondary-level education and only 2% of the sample had a pharmacist as technical director. Continuing education courses were either directly organized by drug manufacturers (one-third of the courses attended by pharmacists) or sponsored by them (more than an additional one-third). CONCLUSIONS: NEs should be considered part of the therapeutic chain and, if appropriately updated or instructed, could play a very important role in the always difficult promotion of rational drug use. Public health institutions and universities should be more actively involved in the provision of independent, unbiased, and essential information on common therapeutic problems, safety concerns, and new drug prescription restrictions.

scholarly journals Prescribing patterns and perceptions of health care professionals about rational drug use in a specialist hospital clinic.

2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Moses A. Ojo ◽  
Cecilia I. Igwilo ◽  
Thomas Emedoh
Keyword(s):  
Health Care ◽  
Drug Use ◽  
Health Care Professionals ◽  
Prescribing Patterns ◽  
Cross Sectional ◽  
Rational Drug Use ◽  
Prescription Practices ◽  
Rational Drug ◽  
Generic Prescribing ◽  
Psychiatric Facilities

Irrational drug use is associated with adverse consequences including drug resistance and avoidable adverse drug reactions. Studies of rational drug use in psychiatric facilities are scanty. This study evaluated prescription practices and perception of health care professionals regarding causes of irrational drug use. A retrospective study conducted at the outpatient clinic of Federal Neuro- psychiatric Hospital, Yaba, Lagos. Data on drug use indicators were analyzed. A cross-sectional assessment of perception of prescribers and dispensers regarding rational drug use was conducted. A total of 600 prescriptions were analyzed. Mean number of drugs per encounter was 3.5 and percentage generic prescribed was 58.5%. Poly-pharmacy (P=0.024, 95% CI=1.082-1.315) and non-generic prescribing (P=0.032, 95% CI=1.495-1.821) were significantly associated with young prescribers. Factors associated with irrational drug use include demand from patients, patients’ beliefs about injection drugs and influence of pharmaceutical sale representatives. Certain aspect of prescribers indicators are still poor in the hospital studied. Health care professionals identified possible associated factors for irrational drug use. Concerted efforts are required to ensure rational drug use especially in psychiatric facilities in Nigeria.

scholarly journals Medication Review for Hospitalized Pediatric Patient: Clinical Pharmacist Interventions

2020 ◽  
Vol 54 (4) ◽  
pp. 218-224
Author(s):  
Merve Nur Işık ◽  
Nazan Dalgıç ◽  
Betül Okuyan ◽  
Zeynep Yıldız Yıldırmak ◽  
Mesut Sancar
Keyword(s):  
Drug Use ◽  
Clinical Pharmacist ◽  
Medication Review ◽  
Pediatric Patients ◽  
Potential Drug ◽  
Drug Related Problems ◽  
Cross Sectional ◽  
Rational Drug Use ◽  
Rational Drug

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.

scholarly journals Evaluation of Rational Drug Use based on Indicators of Diseases and Facilities at Community Health Centers in Districts in Semarang

2019 ◽  
Vol 2 (2) ◽  
pp. 119-124
Author(s):  
Nisa Febrinasari ◽  
Abdur Rosyid ◽  
Leny Angelina
Keyword(s):  
Drug Use ◽  
Community Health ◽  
Community Health Centers ◽  
Data Retrieval ◽  
Essential Medicines ◽  
Homogeneity Test ◽  
Cross Sectional ◽  
Rational Drug Use ◽  
Rational Drug ◽  
The Government

Rational drug use (RDU) is an indicator to evaluates a treatment given to patients, like proper medication, precise diagnosis, precise dosing. Community Health Center (CHC) has the risk of irrational drug use. In this study, researchers selected N and BL CHC, aiming to evaluate the prescribing indicators based on three diseases which are non-pneumonia acute respiratory infection (ARI), non-specific diarrhea and myalgia, and the facility indicators with DOEN (list of essential national medicines) availability and 20 mandatory drugs. This research was a descriptive-analytical study with cross-sectional methods where the data retrieval of the prescribing is taken from January to December 2018. The study used the normality test and homogeneity test before independent sample T-test, from the third outcome of the test, the N and BL CHC could be said to differ significantly of RDU. It can be concluded that rational drug use is reviewed from a prescribing indicator based on disease and facility indicator. The results of RDU are rational in N CHC, in contrast with BL CHC which is not rational with the results of the RDU in N CHC is 101.44% and BL CHC is 89.81%. The results of N CHC is better than BL CHC, which both CHCs have fulfilled the target of the government, for 68% in 2018. In both CHCs for the facility indicator, there are a DOEN and 20 essential medicines.

scholarly journals Prescribing patterns in primary and secondary level government health facilities in a district of Assam: a cross sectional study

2019 ◽  
Vol 6 (5) ◽  
pp. 2077
Author(s):  
Dakshadhwari Upadhyay ◽  
Rashmi Ahmed ◽  
Rupali Baruah ◽  
Manjit Boruah
Keyword(s):  
Drug Use ◽  
Secondary Level ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Essential Drug ◽  
Cross Sectional ◽  
Essential Drug List ◽  
Drug List ◽  
Rational Drug ◽  
Level Government

Background: Indian markets are flooded with more than 100,000 formulations, compared to approximately 350 formulations listed in the World Health Organization (WHO) essential drug list. To promote rational drug use in developing countries, assessment of drug use patterns with the WHO drug use indicators is becoming increasingly necessary. This study was conducted to study the prescribing patterns using WHO prescribing indicators in government healthcare facilities in a district of Assam.Methods: This was a cross sectional study carried out from July to September 2017. Out of total 4 blocks in Tinsukia district one (Ketetong) was randomly selected. All the primary and secondary level government health facilities were included and visited one by one. All the prescriptions on that day of visit were digitally photographed at the pharmacy of the health institution after taking written informed consent from the patient. A total of 353 prescriptions were scrutinized and analyzed using appropriate statistical tests.Results: Out of total 353 prescriptions collected, 11 were illegible and excluded from the analysis. The average number of drugs per encounter was 3.8. In 62.3% of encounters antibiotics were prescribed and injections were prescribed in 30.1% encounters. 71.8% drugs were prescribed by generic name and 56.2% drugs were prescribed from the essential drug list (EDL).Conclusions: The average number of drugs, percentage of injections and antibiotics per encounter was higher than recommended whereas prescription by generic name and from EDL or formulary was lower than recommended. Training of healthcare workers on rational drug use is need of the hour.

scholarly journals Medication Review for Hospitalized Pediatric Patient: Clinical Pharmacist Interventions

2020 ◽  
Vol 54 (4) ◽  
pp. 237-243
Author(s):  
Merve Nur Işık ◽  
Nazan Dalgıç ◽  
Betül Okuyan ◽  
Zeynep Yıldız Yıldırmak ◽  
Mesut Sancar
Keyword(s):  
Drug Use ◽  
Clinical Pharmacist ◽  
Medication Review ◽  
Pediatric Patients ◽  
Potential Drug ◽  
Drug Related Problems ◽  
Cross Sectional ◽  
Rational Drug Use ◽  
Rational Drug

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.

scholarly journals Iranian nurses’ attitudes towards the necessity and barriers to developing nurse prescribing roles

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Azam Naderi ◽  
Maryam Janatolmakan ◽  
Rostam Jalali ◽  
Bahare Andayeshgar ◽  
Alireza Khatony
Keyword(s):  
Drug Prescription ◽  
Cross Sectional Study ◽  
Data Collection Tool ◽  
Cross Sectional ◽  
Effective Measure ◽  
Potential Barriers ◽  
Nursing Managers ◽  
Nurse Prescribing ◽  
Rational Drug ◽  
Prescribing Medication

Abstract Background Prescribing medication by nurses as an approach to rational drug prescription has been proposed in many countries. Nursing prescribing is an effective measure in the management of critically ill patients admitted to intensive care units (ICU). This study investigated the attitude of ICU nurses towards the necessity and the barriers to developing nursing prescribing. Materials and methods In this cross-sectional study, 136 ICU nurses were included by stratified random sampling. The data collection tool was the researcher-made questionnaire. Cronbach’s alpha method was used to evaluate the reliability of the instrument. The validity of the instrument was also verified by the content validity method. To collect the data, the researcher referred to the nurses’ workplace and provided them with a questionnaire and collected it after completion.The collected data were analyzed by IBM SPSS 16 using descriptive and inferential statistics. Results It was revealed that 58.8 % of nurses were familiar with the term ‘nursing prescribing’; a majority (92.1 %) of whom considered it vital to develop this role in the ICU. Moreover, 86 % (n = 98) of the nurses assumed that it is possible to implement this role in ICU. The most potential barriers to its implementation were lack of legitimacy, disapproval of physicians, and the reluctance of nursing managers. Conclusions Most nurses maintained a positive attitude towards nursing prescribing; hence, its legitimacy seems vital in ICUs. For the development of the ‘nurse prescribing’ role, the Nursing System Organization may be helpful.

scholarly journals Practice towards Rational Drug Use at Finotselam and Asirade Zewudie Hospitals Based on WHO Core Drug Use Indicators, Northwest Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Bekalu Dessie ◽  
Getachew Atalaye ◽  
Esubalew Diress ◽  
Alamirew Getahun
Keyword(s):  
Drug Use ◽  
Essential Medicine ◽  
Northwest Ethiopia ◽  
World Population ◽  
Cross Sectional ◽  
Who Criteria ◽  
Rational Drug Use ◽  
Drug List ◽  
Rational Drug ◽  
The World

Background. The rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community with full information and with the lowest possible cost. If one of these is not met, it is referred to as irrational drug use. Many drugs have been sold or prescribed inappropriately in the world, and a significant part of the world population lacks access to essential medicine. The aim of this study was to assess practice towards rational drug use at Finoteselam and Asirade Zewudie hospitals. Methods. A cross-sectional study design was used for this study, and the study was conducted from October 11 to November 30, 2019. A total of 770 prescriptions were selected as per WHO criteria by using systematic random sampling and reviewed with the help of an observational checklist. The data were entered and processed with SPSS version 25 and evaluated using the WHO criteria. Result. The average number of drugs per prescription was 1.8 and 2.05, antibiotics encountered were 77.7% and 72.5%, injections encountered were 5.97% and 7.01%, percentage of drugs prescribed by generic names was 97% and 93.4%, counseling time was 1.6 minutes and 2.25 minutes, and dispensing time was 51.3 seconds and 62.72 seconds at Finoteselam and Asirade Zewudie hospitals, respectively. Conclusion. The majority of WHO core drug use indicators were not met in the two hospitals. The average number of drugs encountered in Asirade Zewudie hospital was slightly higher than the WHO recommended range, whereas the average number of drugs encountered in Finoteselam hospital was exactly equal. The percentage of antibiotics encountered was very high compared with WHO recommendation, but the percentage of injections encountered was below the WHO recommended range and time spent on counseling and dispensing was too short when compared with WHO recommendation. In addition to this, both hospitals had no essential drug list or formulary as well as a key drug list.

scholarly journals Assessment of Prescribing and Dispensing Practices Based on WHO Core Prescribing Indicators in Hospital and Community Pharmacies in Khartoum State - Sudan

2020 ◽  
Vol 1 (3) ◽  
pp. 1-11 ◽  
Author(s):  
Dalia Rabie ◽  
Salah I. Kheder
Keyword(s):  
Drug Use ◽  
Drug Prescription ◽  
Community Pharmacies ◽  
Antibiotic Prescribing ◽  
Continuous Assessment ◽  
Cross Sectional ◽  
Average Percentage ◽  
Rational Drug ◽  
Hospital Pharmacies ◽  
Dispensing Practices

Background Rational drug management has become an increasingly important topic in order to make optimal use of the drug budget to offer health services of the highest possible standard. It is important that continuous assessment for rational prescribing and use of drug have to be carried. Objective of this study was to gather data on existing drug prescription and dispensing practices and to evaluate the prescribing and dispensing indicators as described by the WHO. Method Observational, cross-sectional, prospective study was designed and conducted to evaluate the performance of hospital and community pharmacies in Khartoum state, related to rational drug use and prescribing and dispensing practices during the period from November 2018 to March 2019. 297 Hospital and community pharmacies from public and private sectors were contacted for carrying out this study survey and the collected data were analysed against WHO standards for core drug use indicators. Results The average number of drugs per encounter was 3.98 drugs. Hospital pharmacies had a higher (4.18±1.516) number of drugs prescribed than community pharmacies (3.87±1.331) with significance difference between mean of two types of pharmacies (P = 0.015). The percentage of antibiotic per prescription was (53.7%). Antibiotic prescribing was much higher (54.0%) in the hospital pharmacies compared to (48.6 %) in community pharmacies. The average percentage of injections per prescription at the facilities was found to be (57.6%). The percentage of prescription with written diagnosis was (26%.0) and the percentage of prescriptions with written dose was (78%.0). The average dispensing time was (1.75) minutes, The Percentage of drugs actually dispensed was (55.99%), the average adequacy of labelling of drugs was (30.4%). Overall prescribing and dispensing indicators were higher than WHO standard. Conclusion The degree of poly pharmacy was greater than of WHO criteria. The completeness and rationality of prescription was found suboptimal and components were missed.

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