1
|
Priyadarsini R, Maheswari YN, Prabha ML, Ramya JE. A comparative study on perception and use of generic drugs between public and private health practitioners. J Family Med Prim Care 2023; 12:3222-3227. [PMID: 38361846 PMCID: PMC10866250 DOI: 10.4103/jfmpc.jfmpc_905_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/05/2023] [Accepted: 07/17/2023] [Indexed: 02/17/2024] Open
Abstract
Context The perception of generic drugs may vary significantly between government and private doctors because physicians in the private sector have more prescribing choices and flexibility. Hence, this study was undertaken to analyse the knowledge, attitude and perception (KAP) of government and private physicians on generic drugs. Materials and Methods This was a questionnaire-based cross-sectional study conducted among physicians working in public and private health sectors. The questionnaire had 25 closed-ended questions related to the KAP of generic medicine. The overall scores were categorised using Bloom's cut-off point. The Chi-square or Mann-Whitney U-test was used to compare the differences between the two groups. Results About 80% of the participants in both groups agreed that generic medicines contain the same active ingredients as brand-name drugs, are less expensive and are available in the Indian market. Nearly 84% of government physicians and only 64% of private physicians believed that generic medicines are just as effective and secure as branded medicines (P - 0.003). The majority of physicians from both groups concurred that there is a lack of quality check in generic drug manufacturing, and they require more information about bioequivalence studies. In both categories, about 75% of participants preferred generic medications for their patients. However, in both groups, more than 50% of physicians were concerned about therapeutic failure and expressed reluctance to prescribe generic medications in life-threatening situations. Conclusions Knowledge and acceptance of generic drugs regarding efficacy, safety, bioequivalence and therapeutic failure are low among both government and private physicians.
Collapse
Affiliation(s)
- R. Priyadarsini
- Department of Pharmacology, Tirunelveli Medical College and Hospital, Tirunelveli, Tamil Nadu, India
| | - Y. Nisha Maheswari
- Department of Pharmacology, Tirunelveli Medical College and Hospital, Tirunelveli, Tamil Nadu, India
| | - M. Lakshmi Prabha
- Department of Pharmacology, Tirunelveli Medical College and Hospital, Tirunelveli, Tamil Nadu, India
| | - J. Ezhil Ramya
- Department of Pharmacology, Tirunelveli Medical College and Hospital, Tirunelveli, Tamil Nadu, India
| |
Collapse
|
2
|
Kandasamy G, Almaghaslah D, Almanasef M. An Evaluation of Continuing Medical Education among Pharmacists in Various Pharmacy Sectors in the Asir Region of Saudi Arabia. Healthcare (Basel) 2023; 11:2060. [PMID: 37510500 PMCID: PMC10379422 DOI: 10.3390/healthcare11142060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Continuing medical training is an important component of modern medical practice because it maintains the ability of physicians to provide up-to-date patient care. This study explored pharmacists' involvement in CME activities and investigated the barriers to undertaking CME activities in Saudi Arabia. It also aimed to highlight the obstacles that prevent pharmacists from participating in CE activities. METHODS This study used a cross-sectional self-administered web-based questionnaire. It was conducted among practising pharmacists in various pharmacy fields in the Asir region of Saudi Arabia. The structured questionnaire consisted of four domains. A convenience sampling strategy was used to select and recruit study participants. The results were described in terms of frequencies and percentages. A Chi-square test was used to assess the differences for categorical data. p value of <0.05 was considered significant. RESULTS AND CONCLUSIONS A total of 173 pharmacists participated in the study. Attending the conference was the most popular activity (67%), followed by training courses (61.8%) and approved web-based activities (60.1%). Regarding barriers that prevented pharmacists from participating in CME activities, a lack of a scientific database or books was the top-rated barrier that hindered pharmacists from obtaining the required CME hours (79.8%). Another important barrier was the cost of the activities (74.6%). Regarding the area of practice for which pharmacists would be interested in attending CME activities, public health was the favourite (89.6%), followed by personal skills (82.7%). Gathering the required CME hours for re-registration was the main motive for attending CME activities in most of the pharmacy sectors. Policymakers should consider shifting the current CME system to the Continuing Professional Development (CPD) model, which promotes engagement in professional development activities that are relevant to the scope of practice.
Collapse
Affiliation(s)
- Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia
| | - Dalia Almaghaslah
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia
| | - Mona Almanasef
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia
| |
Collapse
|
3
|
Abudalo R, Abudalo R, Alqudah A, Abuqamar A, Abdelaziz A, Alshawabkeh M, Taha L. Pharmacy practitioners' practice, awareness and knowledge about herbal products and their potential interactions with cardiovascular drugs. F1000Res 2022; 11:912. [PMID: 36212547 PMCID: PMC9520230 DOI: 10.12688/f1000research.121709.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 01/13/2023] Open
Abstract
Background: Herbal medicine use is widespread among patients, as community pharmacies may provide such products. Therefore, pharmacy practitioners should be aware of potential herbal products' adverse effects and herb-drug interactions, particularly with medications for comorbid diseases, such as cardiovascular drugs, in which pharmacy practitioners need to have good knowledge to provide patients with relevant advice to get optimal and safe therapeutic outcomes. Accordingly, the study is designed to assess the knowledge and awareness of pharmacy practitioners regarding herbal product dispensing and cardiovascular drug interaction in Jordan and view their role in patients' counselling to set up safe and effective drug use. Methods: A cross-sectional study was conducted in Jordan using an online formatted questionnaire distributed to pharmacy practitioners working in community pharmacies. Descriptive and analytical statistics were performed for the responses using the Statistical Package for the Social Sciences (SPSS) software, version 26. Results: Out of 508 participants, 41.7% had medium knowledge of herbal products pertaining mainly to university education (68.1%); 55.1% of participants dispensed herbal products without prescriptions for obesity and weight reduction (72.8%) and gastrointestinal problems (70.9%); this is because respondents agreed that herbal remedies are safe (28.5%) and effective (38.4%). Whilst the knowledge level of respondents about herbal medicine interaction with cardiovascular medication was medium, with a mean of 1.94, as this interaction may result in potentially serious consequences, 40.7% of respondents strongly agreed to gain more knowledge about the side effects of herbal products and medicine interactions through educational courses. Conclusions: The pharmacy practitioners had medium knowledge of herbal products; however, more attention should be paid to herb-drug interactions in the pharmacy educational curriculum. Additionally, pharmacy practitioners need to refresh their knowledge by attending periodic educational courses and by using reliable resources for information about herbal products in order to provide effective and competent pharmaceutical care.
Collapse
Affiliation(s)
- Rawan Abudalo
- Department of clinical pharmacy and pharmacy practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Zarqa, 13133, Jordan,
| | - Razan Abudalo
- Department of Radiology, Jordanian Royal Medical Services, Amman, Jordan
| | - Abdelrahim Alqudah
- Department of clinical pharmacy and pharmacy practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Zarqa, 13133, Jordan
| | - Ayman Abuqamar
- Department of Oncology and Hematology, Jordanian Royal Medical Services, Amman, Jordan
| | - Amr Abdelaziz
- Department of clinical pharmacy and pharmacy practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Zarqa, 13133, Jordan
| | - Maram Alshawabkeh
- Department of clinical pharmacy and pharmacy practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Zarqa, 13133, Jordan
| | - Luma Taha
- Department of clinical pharmacy and pharmacy practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Zarqa, 13133, Jordan
| |
Collapse
|
4
|
Alemu S, Tadesse N, Mulugeta T, Assefa D. Generic substitution for prescribed brand medicines in Ethiopia: knowledge, attitude and practice among pharmacy professionals in community drug retail outlets. BMC Health Serv Res 2022; 22:926. [PMID: 35854313 PMCID: PMC9295362 DOI: 10.1186/s12913-022-08330-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/13/2022] [Indexed: 11/14/2022] Open
Abstract
Background Generic substitution is a good approach to reduce pharmaceutical expenses without compromising healthcare quality. Yet, the practice of generic substitution has been contentious due to concerns on quality and efficacy. Objective This study was aimed to assess knowledge, attitude and practice among pharmacy professionals toward generic substitution in community drug retail outlets in Jimma town, Southwest Ethiopia. Methods A descriptive cross-sectional study was conducted among pharmacy professionals working in community drug retail outlets. Data was collected using a self-administered questionnaire. Knowledge was tested using a 3-point response format consisting of “Yes,” “No” and “I am not sure.” Attitude was evaluated using the 5-point Likert scale ranging from 1(strong agreement) to 5 (strong disagreement). The practice was examined as never, seldom, sometimes, often, and always with scores ranging from 0 to 4. The influences of socio-demographic factors on knowledge, attitude, and practice were tested using the Mann–Whitney U and Kruskal–Wallis tests as appropriate. P ≤ 0.05 was considered statistically significant. Results The mean knowledge score of participants regarding generic medicines was 5.75 ± 1.79. Only 32 respondents (30.2%) of the participants were knowledgeable about the generic substitution. 54 (50.9%) of respondents had positive attitude toward generic substitution and 52 (49.1%) had practiced generic substitution. The year of experience had a significant effect on knowledge (X2 = 9.14, p = 0.01) and practice (X2 = 4.71, p = 0.03) of generic substitution. Conclusions Our study found that pharmacy professionals working in community drug retail outlets in Jimma town had lack of knowledge about generic substitution. Conversely, an enormous amount of participants had positive attitude toward generic substitution and nearly half of them had practiced generic substitution. The year of experience had a significant effect on knowledge and practice of generic substitution.
Collapse
Affiliation(s)
- Sintayehu Alemu
- School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Natnael Tadesse
- School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tidenek Mulugeta
- School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Desta Assefa
- School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
5
|
Al-Arifi MN. Assessment of Knowledge, Attitudes, and Factors Influencing the Selection Student of Generic Medicine. Front Public Health 2021; 9:767128. [PMID: 34938706 PMCID: PMC8685314 DOI: 10.3389/fpubh.2021.767128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Generic replacements for branded medicines have become a typical practice among registered pharmacists all over the world. Therefore, this study was aimed to determine the influence of the knowledge and attitudes of PharmD students and other factors on the selection of unbranded medicines. Methods: A descriptive, cross-sectional study was conducted through Google Forms to collect data using self-reported questionnaires. The data was collected over a period of 3 months, from January to March 2021, among junior level pharmacy students who are currently undertaking a PharmD course at the King Saud University, College of Pharmacy, Riyadh, Saudi Arabia. Results: The mean age of the students was 21.05± (SD = 1.03), majority of students 70.2% (n = 134) were able to define the term generic medicine, and about 65% (n = 123) were able to correctly define bioequivalence. More than half of the students, 56.5% (n = 108) lacked knowledge about the pharmacokinetic parameters of generic products. Meanwhile, the majority, 85% (n = 122), supported generics over branded medicines, and about 66% (n = 99) agreed that wider use of generic medicines would lead to less money required for the research and development of new pharmaceuticals. Conclusion: Findings revealed that most pharmacy students possess sufficient knowledge of generic medicines, although knowledge in some aspects remains lacking.
Collapse
Affiliation(s)
- Mohamed N Al-Arifi
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
6
|
Kamphuis BW, Kanavos P. Assessing pricing and reimbursement policies for generic pharmaceuticals in the MENA region for improved efficiency, affordability and generic penetration. HEALTH POLICY OPEN 2021. [DOI: 10.1016/j.hpopen.2021.100045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
7
|
Zia N, Ibrahim MIM, Adheir F, Babar ZUD. Identifying priority medicines policy issues for Qatar: exploring perspectives and experiences of healthcare professionals through a qualitative study. BMJ Open 2021; 11:e054150. [PMID: 34819289 PMCID: PMC8614137 DOI: 10.1136/bmjopen-2021-054150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To identify priority medicines policy issues, including the 'use' and 'access to medicines' in Qatar. DESIGN In this qualitative study, general inductive method was used and semi-structured exploratory interviews conducted. SETTING Stakeholders from a broad range of academic and healthcare practitioners in Qatar. PARTICIPANTS Exploratory, semi-structured interviews were conducted with 21 stakeholders throughout Qatar. The inclusion criteria include (a) participants working or involved in the Qatar's healthcare system, (b) participants having experience or working knowledge of medicine policy documents, different facets of it, use of medicines and access to medicines, (c) as well as participants well versed in the English language. It was intended to cover stakeholders from a broad range of healthcare and policy institutions in Qatar. PRIMARY AND SECONDARY OUTCOME MEASURES All participants were involved in semi-structured, audio-recorded interviews, which were then transcribed verbatim, coded into NVivo V.12 and followed by thematic analysis to identify the common themes. Perceptions, experiences and opinions regarding Qatar's medicines policy issues were recorded. RESULTS This study found challenges related to the availability of pharmaceuticals in Qatar, including medicines registration process. There is no comprehensive national medicines policy in Qatar, however, there are a number of rules, regulations, policies and procedures in place. The community pharmacy services provided are mostly 'traditional' with less emphasis on pharmacists' extended roles and/or cognitive services. The study identifies several areas for improvement including extending the role of the pharmacist, improve the prescribing of antibiotics, medicines compliance and counselling for consumers, pharmacovigilance, implementation of generic medicines policies, as well as the need for a national health record database. CONCLUSIONS The findings suggest that in the last 20 years, Qatar has moved towards advancing healthcare; however, there are gaps and opportunities. The strategies need to be developed to resolve access to medicines issues, the priority being medicines registration, import and so on. With the rise of chronic diseases and a growing population, there is also a need to work to improve medicines adherence among patients.A national medicines policy should be developed through a consultative broad-based process in which prescribers, physicians, pharmacists and healthcare professionals be given a chance to contribute.
Collapse
Affiliation(s)
- Nadeem Zia
- Department of Pharmacy, Sidra Medicine, Doha, Qatar
| | | | | | | |
Collapse
|
8
|
Altamimi M, Hamdan M, Badrasawi M, Allahham S. Knowledge, Attitudes and Practices Related to Dietary Supplements among a Group of Palestinian Pharmacists. Sultan Qaboos Univ Med J 2021; 21:613-620. [PMID: 34888082 PMCID: PMC8631217 DOI: 10.18295/squmj.4.2021.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/16/2020] [Accepted: 10/07/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The use of dietary supplements (DS) has increased, but due to a lack of related regulations, the prescription of DS depends on pharmacists' knowledge. Hence, this study aimed to evaluate the knowledge, attitudes and practices (KAP) related to DS among community-based pharmacists. METHODS This study followed a cross-sectional design targeting community pharmacists in West Bank, Palestine between September and December 2019. Selected participants filled a self-administered questionnaire regarding their KAP related to DS. The questionnaire contained 15 items: five questions on knowledge, seven on practices and three on attitudes. RESULTS At a 90% response rate, 56.2% of the representative sample was female. The participants' experience was distributed almost equally across the categories of 0-5, 5-10 and over 10 years. Additionally, a majority of the participants were the responsible pharmacist and/or the pharmacy owner. Overall, the participants showed a moderate level of knowledge about DS with a mean score of 3.68 ± 1.1 out of 5; the correct answers ranged from 3.6% to 75.3% of the surveyed participants. The practices with the highest frequencies were as follows: taking DS sometimes (79.9%), taking supplements from well-known brands (56.2%), giving supplements to any patient (55.7%), selling supplements according to the participants' knowledge (74.2%) and providing advice about supplements (73.2%). The questions about the pharmacists' attitudes towards DS market regulation revealed that more than half (52%) of the participants believed that it was suitable. The association between knowledge score and practices was highly significant (P <0.001). CONCLUSION The study revealed that participants had moderate knowledge about DS. Additionally, knowledge and practices were highly connected.
Collapse
Affiliation(s)
| | - May Hamdan
- Department of Healthy and Therapeutic Nutrition, Palestine Polytechnic University, Hebron, Palestine
| | | | - Saad Allahham
- Pharmacy, An-Najah National University, Nablus, Palestine
| |
Collapse
|
9
|
Qu J, Zuo W, Wang S, Du L, Liu X, Gao Y, Li J, Pan H, Du X, Mei D, Took RL, Schafermeyer KW, Lukas S, Zhang B. Knowledge, perceptions and practices of pharmacists regarding generic substitution in China: a cross-sectional study. BMJ Open 2021; 11:e051277. [PMID: 34663661 PMCID: PMC8524276 DOI: 10.1136/bmjopen-2021-051277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To evaluate pharmacists' knowledge, perceptions and practices towards generic substitution in the 11 pilot locations in China. DESIGN An online cross-sectional survey using questionnaires was conducted. A convenience sampling technique was implemented to recruit pharmacists. SETTING AND PARTICIPANTS The study took place in medical institutions of 11 pilot locations that participated in the pilot national centralised procurement programme in 2019. Two thousand two hundred and ninety-one pharmacists including hospital pharmacists or community pharmacists based on health-systems or clinics participated in the study. RESULTS Most of the participants had the good knowledge of requirements for evaluating the quality and efficacy of generic drugs (n=2118; 92.4%), and the definition of generic drugs (n=2078; 90.7%). In terms of perceptions, 67.3% of respondents were of the opinion that generic drugs are equally as effective as the brand-name drugs, and 69.0% of respondents were of the opinion that generic drugs are as safe as brand equivalents. A high percentage of participants supported the policy of generic substitution (n=1634; 71.4%). A significant positive correlation was demonstrated between total knowledge score and total perception score (ρ=0.267; p<0.001). Efficacy, safety and the direction of national policies and hospital regulations were the main factors affecting pharmacists' willingness to dispense generic drugs. CONCLUSIONS The study identified gaps in respondents' knowledge and perceptions of generic substitution. Pharmacists who are more knowledgeable in generic drugs tend to hold a more supportive attitude towards generic substitution. Although it appeared that pharmacists in China have largely accepted generic substitution, they still have concerns regarding the reliability and quality of generic drugs. The current issues need to be addressed for the realisation of the true value of generic drugs as part of the country's healthcare cost-containment strategy as well as the implementation of generic substitution policy in China.
Collapse
Affiliation(s)
- Jinghan Qu
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Wei Zuo
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Shaohong Wang
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Liping Du
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Xin Liu
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Yang Gao
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Jiantao Li
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Hui Pan
- Department of Medical Administration, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Xiaoli Du
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Dan Mei
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Roxane L Took
- Department of Pharmacy Practice, St. Louis College of Pharmacy, St Louis, Missouri, USA
| | - Kenneth W Schafermeyer
- Department of Pharmaceutical and Administrative Sciences, St. Louis College of Pharmacy, St Louis, Missouri, USA
| | - Stephanie Lukas
- Department of Pharmaceutical and Administrative Sciences, St. Louis College of Pharmacy, St Louis, Missouri, USA
| | - Bo Zhang
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| |
Collapse
|
10
|
Li WJ, Xia MJ, Gong SW, Ding YF. Perceptions of Generic Drugs in the Pharmacists of Public Hospitals: A Cross-sectional Survey in Hubei Province of China. Curr Med Sci 2021; 41:987-995. [PMID: 34476663 DOI: 10.1007/s11596-021-2412-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 02/16/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Generic drugs provide an opportunity for savings in drug expenditure since they are available at a lower cost and do not affect patients' health. A better understanding of pharmacists' knowledge, attitudes, and perception can promote the quality use of generic drugs. The objective of this study was to investigate the knowledge, attitudes, and perception of pharmacists from tertiary hospitals in China regarding generic drugs. METHODS A cross-sectional survey using a postal questionnaire was conducted, which was sent to 200 hospital pharmacists randomly selected from tertiary hospitals in Hubei Province. A total of 125 questionnaires out of 200 were received. Of the respondents, 80 were female and 45 were male. RESULTS The majority of respondents (87.2%) could clearly distinguish between original and generic drugs. Pharmacists agreed that generic drugs were less effective (52.8%) and produced more side effects (52%). Fortynine respondents thought that generic drug products were not adequately tested. Approximately 78% and 60% of the pharmacists indicated that generic substitution was not feasible for drugs with narrow therapeutic windows and drugs for critical diseases, respectively. Most of them supported the recommendation of generic drugs based on professional judgment. CONCLUSION Our study showed that a considerable portion of Chinese hospital pharmacists hold negative perceptions of generic drugs. Interventions to improve pharmacists' knowledge of generic drugs are needed.
Collapse
Affiliation(s)
- Wei-Jie Li
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Mei-Jun Xia
- Department of Pharmacy Business and Administration, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shi-Wei Gong
- Department of Pharmacy Business and Administration, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Yu-Feng Ding
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|
11
|
Zawahir S, Lekamwasam S, Halvorsen KH, Rose G, Aslani P. Self-medication Behavior with antibiotics: a national cross-sectional survey in Sri Lanka. Expert Rev Anti Infect Ther 2021; 19:1341-1352. [PMID: 33792479 DOI: 10.1080/14787210.2021.1911647] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Antibiotic self-medication is common in low- and middle-income countries. This study aimed to evaluate the Sri Lankan public's knowledge about and attitudes toward antibiotic use and self-medication, and factors associated with self-medication. METHODS A national cross-sectional, interviewer-administered, survey of a random household sample (N = 1100) was conducted. Factor analysis of the attitudinal items was conducted to investigate the factors associated with antibiotic self-medication. RESULTS A response rate of ninety-one percent (n = 998) responded. Knowledge about antibiotics was poor (mean = 12.5; SD = 3.5; (scale 0-27)). Half had previously used an antibiotic once in the past three months. About 11% (108/998) had self-medicated the last time they took antibiotics; mostly obtained from a pharmacy (82%; 89/108). Three attitudinal factors were obtained, explaining 56.1% of the variance. Respondents were less likely to self-medicate if they did not support ease of access to antibiotics from pharmacies (p< 0.001) and situational use of antibiotics (p= 0.001); supported appropriate use of antibiotics (p= 0.003); and had greater knowledge about prescription requirements for antibiotics (p= 0.004). CONCLUSION There is limited knowledge about, and a high rate of self-medication with antibiotics.Factors contributing to self-medication could be addressed with appropriate public education campaigns, and policy changes.
Collapse
Affiliation(s)
- Shukry Zawahir
- , The University of Sydney School of Pharmacy, Faculty of Medicine and Health, NSW, Australia.,Central Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Sarath Lekamwasam
- Population Health Research Centre, Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Kjell H Halvorsen
- Department of Pharmacy, UiT the Arctic University of Norway, Tromsø, Norway
| | - Grenville Rose
- Centre for Social Research in Health, The University of New South Wales, NSW, Australia
| | - Parisa Aslani
- , The University of Sydney School of Pharmacy, Faculty of Medicine and Health, NSW, Australia
| |
Collapse
|
12
|
Osemene KP, Ihekoronye MR, Lamikanra A. Knowledge, attitudes, perceptions and practices of community pharmacists about generic medicine in Nigeria. ACTA ACUST UNITED AC 2020. [DOI: 10.1177/1741134320962843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Although generic medicines are used extensively in Nigeria information from community pharmacists about these drugs are scanty and therefore inadequate. This is why this study has been designed to bridge the knowledge gap, attitudes, as well as the perception and practice of community pharmacists about generic medicines in Nigeria. Method A questionnaire-guided cross-sectional survey was used to collect data from 380 community pharmacists who were randomly selected from community pharmacies between April and June 2019 in Southwestern Nigeria. Data generated in the course of this study was analysed with the Statistical Package for Social Sciences version 18. Descriptive statistics were used to summarize data. Chi-square was used to test proportions and to determine associations between categorical variables. Pearson’s Correlation Coefficient was used to determine correlation between dependent variables. Result Mean knowledge score of community pharmacists about generic medicines(GM) was 5.6 ± 2.9 out of a total maximum score of 10. Results showed that 47.9% of respondents had poor knowledge, 27.6% average knowledge and 24.5% good knowledge about GM. Knowledge was significantly associated (p = .000) with all demographic characteristics except professional qualifications. A majority (89%) of the respondents were of the view that patients need more explanations when GMs are dispensed to them. In addition, 90.3% of the respondents were of the opinion that GM will improve access to medicine because they are cheaper and easily affordable. About 93% practice generic substitution without consulting prescribing physicians. Furthermore, 85% of the respondents claim they stock mainly GMs. Conclusion Community pharmacists in Nigeria had a positive attitude, perception and practice about GM, but exhibited sub-optimal knowledge in understanding issues concerning generic medicines. It is concluded that there is the need for continuous training and education to enhance professional knowledge of pharmacists in the area of GM substitution.
Collapse
Affiliation(s)
- Kanayo P Osemene
- Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | | |
Collapse
|
13
|
Mohammed AS, Woldekidan NA, Mohammed FA. Knowledge, attitude, and practice of pharmacy professionals on generic medicines in Eastern Ethiopia: A cross-sectional study. PLoS One 2020; 15:e0235205. [PMID: 32658918 PMCID: PMC7357759 DOI: 10.1371/journal.pone.0235205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 06/11/2020] [Indexed: 11/05/2022] Open
Abstract
Background Generic medicines are similar to innovator medicine in terms of safety, quality, efficacy, dosage form, strength, and route of administration. They have the same therapeutic use to innovator medicines and available at a far lower price. However, health professionals' poor knowledge and attitude may limit its utilization. The present study aimed at assessing the knowledge, attitude, and practice of pharmacy professionals towards generic medicines in Harar city, Eastern Ethiopia. Methods A cross-sectional survey was conducted among community pharmacists in Harar city. A self-administered thirty-three item questionnaire on Knowledge, attitude, and practice of community pharmacists was utilized. Logistic regression analysis was performed to predict the determinants of knowledge and attitude of pharmacists. An odds ratio at 95% confidence interval along with a p-value < 0.05 was considered significant. Results Among 80 community pharmacists’ approached, 74 completed the survey, providing a response rate of 92.5%. Sixty-seven percent of the respondents knew that generic drugs are bioequivalent to brand drugs and claimed generic medicines are cheaper (86.5%). Nearly half (48.6%) of participants believe that generic medicines are less effective and slower in the onset of action (58.1%). More than half (54.1%) of study participants revealed their lack of belief in generic medicine as a factor hindering the selection and dispensing of generic medicines. In multivariate logistic regression, experience in community pharmacy practice (Adjusted odds ratio (AOR = 2.18, 95%CI: 1.21–63.1) and Sex (AOR = 3.88, 95%CI: 2.12–39.62) were significantly associated with knowledge and attitude toward generic medicines, respectively. Conclusion The current study revealed that there is a gap in the knowledge and attitude of community pharmacists towards generic and brand drugs. More than averages of the respondents have known the concept of generic medicine including their right to perform generic substitution and had a positive attitude toward generics. Female pharmacists were more likely to have a positive attitude and the overall knowledge was higher in those who have more than 5 years of work experience.
Collapse
Affiliation(s)
- Ammas Siraj Mohammed
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
- * E-mail:
| | | | - Fuad Adem Mohammed
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| |
Collapse
|
14
|
Marupuru S, Axon DR, Slack MK. How do pharmacists use and recommend vitamins, minerals, herbals and other dietary supplements? Altern Ther Health Med 2019; 19:229. [PMID: 31438941 PMCID: PMC6704661 DOI: 10.1186/s12906-019-2637-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/11/2019] [Indexed: 11/18/2022]
Abstract
Background Use of complementary and alternative medicine (CAM), including vitamins, minerals, herbals, and other dietary supplements, is widespread in the United States (ranging from 24% in Hispanics to 50% in American Indians). Pharmacists are an accessible source for healthcare information, but little is known about their use of CAM products and to whom they would recommend these products. Methods A cross-sectional survey was sent via email to pharmacists licensed in one state in the United States in 2015. The survey included items about their use of 10 vitamins and minerals, and 21 herbal or other dietary supplements, as well as reasons for use, conditions used to treat, if they would recommend the product to patients, family, or friends, their perception of CAM safety and effectiveness, and four demographic questions. Descriptive statistics were used to summarize the data, and a chi-square test was used to determine differences between pharmacists’ use of vitamins/minerals and herbals/other dietary supplements. The a priori alpha level was 0.05. Results A total of 639 pharmacists completed the survey. Female pharmacists used vitamins/minerals (p = 0.031) and herbals/others (p = 0.039) more than male pharmacists. Older pharmacists used herbals/others more than younger pharmacists (p < 0.001). Fifty-nine percent thought the dietary supplements in the survey were safe while 32% reported they were effective. Seventy-eight percent of respondents reported use of any vitamin or mineral product versus 42% who reported use of any herbal or other dietary supplement. Commonly used products included: multivitamins (91%), vitamin C (71%), fish oil (65%), probiotics (53%), and fiber (53%). The most commonly reported reason for use was general health and wellness (17–90%). Pharmacists most commonly recommend fiber/psyllium (94%) and calcium (90%) to patients, family, and friends. Conclusions Pharmacists in this survey selectively used vitamins, minerals, herbals and other dietary supplements, and recommended some of the more commonly used products to patients, family and friends. This is valuable information given that pharmacists are frontline healthcare professionals who may be asked to provide advice about these products. Electronic supplementary material The online version of this article (10.1186/s12906-019-2637-y) contains supplementary material, which is available to authorized users.
Collapse
|
15
|
Abdel Rida N, Mohamed Ibrahim MI, Babar Z. Pharmaceutical pricing policies in Qatar and Lebanon: narrative review and document analysis. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2019. [DOI: 10.1111/jphs.12304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
16
|
Zawahir S, Lekamwasam S, Aslani P. A cross-sectional national survey of community pharmacy staff: Knowledge and antibiotic provision. PLoS One 2019; 14:e0215484. [PMID: 31022197 PMCID: PMC6483176 DOI: 10.1371/journal.pone.0215484] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/02/2019] [Indexed: 11/19/2022] Open
Abstract
Background Pharmacists’ knowledge about the clinical and legal aspects of antibiotic supply has an impact on appropriate dispensing practice. There are limited studies evaluating community pharmacists’ knowledge of antibiotic dispensing in low and middle-income countries, including Sri Lanka. We aimed (i) to evaluate community pharmacy staff’s self-reported knowledge about antibiotics and dispensing behaviour of antibiotics without a prescription, and (ii) to identify possible factors impacting their antibiotic dispensing behaviour. Methods A cross-sectional survey was conducted among a random sample (n = 369) of community pharmacies across all nine provinces in Sri Lanka using a self-administered questionnaire on their antibiotic knowledge and dispensing practice. Data were analysed using descriptive and inferential statistics including; t-test, one-way ANOVA or chi-square test, and binary and multiple logistic regression. Results A total of 265 pharmacy staff (210 (79%) pharmacists and 55 (21%) assistants) responded. Overall mean antibiotic knowledge score was 26.1 (SD 3.9; range 1–33, max possible score 34). The overall mean knowledge score t(263) = 2.41, p = 0.017, specific knowledge about antibiotic resistance (ABR) t(262) = 4.98, p = 0.021 and legal aspects of antibiotic dispensing χ2(1, N = 265) = 8.55, p = 0.003) were significantly higher among pharmacists than assistants. One in every three pharmacy staff reported that they dispensed antibiotics without a prescription on patient request; however the proportion was close to half when the patient was known to them. About 30% of the staff reported to have supplied antibiotics for minor infections in the week prior to the survey. However, there was no significant difference in the supply between pharmacists and assistants except for acute sore throat (12% vs 23%, respectively; p = 0.040). Those pharmacists with higher ABR knowledge were less likely to give out antibiotics without a prescription for viral infections in adults (Adj. OR = 0.73, 95% CI: 0.55–0.96; p = 0.027) and children (Adj. OR = 0.55, 95% CI: 0.38–0.80; p = 0.002). Awareness of legal aspects of antibiotic supply reduced overall dispensing (Adj. OR = 0.47, 95% CI: 0.30–0.75; p = 0.001), and specifically for bacterial infections in adults (Adj. OR = 0.45, 95% CI: 0.20–0.99; p = 0.047). Knowledge about antibiotic use and misuse reduced the likelihood of illegal dispensing for common cold (Adj. OR = 0.75, 95% CI: 0.60–0.94; p = 0.011) and acute diarrhoea (Adj. OR = 0.76, 95% CI: 0.58–0.99; p = 0.048). Conclusion Despite the law prohibiting provision, antibiotic dispensing without a prescription continues in community pharmacies in Sri Lanka. Appropriate antibiotic dispensing was associated with high levels of pharmacists’ legal and clinical knowledge about antibiotics. Strategies to change the current practice are urgently needed.
Collapse
Affiliation(s)
- Shukry Zawahir
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
- * E-mail:
| | - Sarath Lekamwasam
- Population Health Research Centre, Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Parisa Aslani
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| |
Collapse
|
17
|
Munsour EE, Awaisu A, Hassali MAA, Ali H, Dabbous Z. A comparative evaluation of written medicine information of antidiabetic medicines from Qatar, Australia and Europe. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1620904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Emad Eldin Munsour
- Pharmacy and Drug Control Department, Ministry of Public Health, Doha, Qatar
| | - Ahmed Awaisu
- College of Pharmacy, Qatar University, Doha, Qatar
| | | | - Hamda Ali
- Diabetes/Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Zeinab Dabbous
- Diabetes/Endocrinology, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
18
|
Shraim NY, Al Taha TA, Qawasmeh RF, Jarrar HN, Shtaya MAN, Shayeb LA, Sweileh WM. Knowledge, attitudes and practices of community pharmacists on generic medicines in Palestine: a cross-sectional study. BMC Health Serv Res 2017; 17:847. [PMID: 29282055 PMCID: PMC5745619 DOI: 10.1186/s12913-017-2813-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 12/18/2017] [Indexed: 11/10/2022] Open
Abstract
Background Generic substitution in several countries has become a common practice. Besides, it is considered as a major cost minimizing strategy meant to contain pharmaceutical expenditure without compromising healthcare quality. However, the safety and quality issues of generic products are of top concerns of general practitioners and health work professionals. This study aimed to investigate community pharmacist’s knowledge, attitudes and practices toward generic medicines in Palestine. Methods This study was a cross-sectional observational study employing a self-administered questionnaire. The questionnaire was of four main sections: demographic and practice details of the participants, knowledge, attitudes and the influencing factors related to selection and dispensing of generic medicines. A convenience sampling technique was implemented in this study in which the data collection form was distributed in West Bank- Palestine among a set of practicing pharmacists. Mann-Whitney-U or Kruskal-Wallis tests were used to comparison of different issues as appropriate. P-values of <0.05 were considered significant. Results A total of 302 community pharmacists were interviewed, slightly more than half were males (52.3%). The mean knowledge score of participants regarding generic medicines was (5.91 ± 1.27) where the highest score was 8 of 10. Knowledge score was not significantly influenced by any of the socio-demographic characteristics. Our data showed that most of included pharmacists in the study (95.4%) agreed that health authorities should implement bioequivalence policies prior to marketing approval of generics, while 87.4% of participants agreed that they should be given the right to substitute generics and the majority (62.3%) support generic substitution for brand name drugs in all cases when a generic is available The main two factors affect pharmacists’ selection and dispensing of generic medicines are personal faith in the product (86.1%) and cost effectiveness of generic medicines (84.1%). Conclusions Generic medicines substitution among pharmacists is widespread and prevalent. Our data found that participant pharmacists in Palestine had basic knowledge with regards to generic medicine. However, their knowledge score pertaining the technical and regulatory aspects of bioequivalence and pharmacokinetic parameters in particular was insufficient. Electronic supplementary material The online version of this article (10.1186/s12913-017-2813-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Naser Y Shraim
- Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
| | - Tasneem A Al Taha
- Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Rawan F Qawasmeh
- Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Hiba N Jarrar
- Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Maram A N Shtaya
- Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Lama A Shayeb
- Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Waleed M Sweileh
- Department of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| |
Collapse
|
19
|
Shraim NY, Shawahna R, Sorady MA, Aiesh BM, Alashqar GS, Jitan RI, Abu Hanieh WM, Hotari YB, Sweileh WM, Zyoud SH. Community pharmacists' knowledge, practices and beliefs about complementary and alternative medicine in Palestine: a cross-sectional study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:429. [PMID: 28851351 PMCID: PMC5575941 DOI: 10.1186/s12906-017-1940-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 08/21/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Complementary and alternative medicine (CAM) utilization is dramatically increasing among patients. As community pharmacies are a major provider of CAM products, community pharmacists need to have the sufficient knowledge and information to advice their patients, answer their inquiries and to be proactive in the healthcare process to ensure optimal therapy outputs and minimize both drug-drug and drug-herb interactions. Therefore, the main objective of this study was to assess the knowledge, beliefs, and practices of community pharmacists in Palestine about CAM. METHODS The study was conducted in a cross-sectional design in which a questionnaire was administered on a sample of licensed community pharmacists from Palestine. The questionnaire was of 5 sections: demographic and practice details of the participants, practice, beliefs, and knowledge about CAM. Mann-Whitney-U or Kruskal-Wallis tests were used to comparison of different issues as appropriate. P-values of <0.05 were considered significant. RESULTS A total of 284 community pharmacists were surveyed, however, 281 were included in the analysis as they met inclusion criteria. Out of the 281, 149 (53.0%) of the participants were males and the rest were females. About 40% of the participants were between 20 to 29 years old. Pharmacists frequently recommended CAM modalities. Exercises (84.0%) and food supplements (82.6%) were the most commonly recommended modalities. In the last year, vitamin B12 was the most frequently prescribed supplement. The median knowledge score was 5 out of 8 and the median beliefs about CAM score was 4.0 out of 7.0. CONCLUSIONS CAM recommendations by pharmacists appear to be commonplace. Although their knowledge scores were fair to average, pharmacists still need more education and training about CAM in order to be more qualified to provide better pharmaceutical care and improve their patient's outcome.
Collapse
Affiliation(s)
- Naser Y. Shraim
- 0000 0004 0631 5695grid.11942.3fDepartment of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ramzi Shawahna
- 0000 0004 0631 5695grid.11942.3fDepartment of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Muna A. Sorady
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Banan M. Aiesh
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ghadeer Sh. Alashqar
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Raghad I. Jitan
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Waed M. Abu Hanieh
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Yasmeen B. Hotari
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Waleed M. Sweileh
- 0000 0004 0631 5695grid.11942.3fDepartment of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sa’ed H. Zyoud
- 0000 0004 0631 5695grid.11942.3fPalestine Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| |
Collapse
|
20
|
El-Jardali F, Fadlallah R, Morsi RZ, Hemadi N, Al-Gibbawi M, Haj M, Khalil S, Saklawi Y, Jamal D, Akl EA. Pharmacists' views and reported practices in relation to a new generic drug substitution policy in Lebanon: a mixed methods study. Implement Sci 2017; 12:23. [PMID: 28212657 PMCID: PMC5316154 DOI: 10.1186/s13012-017-0556-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 02/14/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Governments in both developed and developing countries have adopted generic drug substitution policies to decrease pharmaceutical expenditures and improve access to medicine. In August 2015, the Ministry of Public Health (MOPH) in Lebanon introduced generic drug substitution and a unified medical prescription form as policy instruments to promote generic drug use. The objective of this exploratory study was to examine the attitudes of community pharmacists and the reported practices in relation to the implementation of the new generic drug substitution policy. METHODS We used a cross-sectional mixed methods approach composed of self-administered questionnaires and semi-structured interviews. The study population consisted of community pharmacists in Lebanon. We randomly approached one pharmacy personnel from each selected community pharmacy. We conducted descriptive analyses to assess responses to questionnaire and regression analyses to understand associations between responses and respondent demographics. We analyzed qualitative data thematically. RESULTS Out of 204 invited community pharmacies, 153 pharmacies participated (75% response rate). The majority of respondents (64%) were in favor of generic drug substitution; however, less than half (40%) indicated they have substituted brand drugs for generic equivalents. Moreover, 57% indicated that the existing pricing system discourages them from performing generic drug substitution. Most respondents indicated that physicians are overusing the "non-substitutable" option (84%) and that there are technical problems with processing the new prescription form (78%). Less than half (47%) reported that the MOPH is performing regular audits on the forms collected by the pharmacy. While 45% of the respondents indicated that consumers have accepted most of the generic substitutions, 21% perceived the increase in generic drug dispensing to be significant. Findings suggested a potentially significant association between being informed about generic drugs and respondents' support of the policy. Suggested strategies to address implementation challenges included strengthening stewardship function of MOPH, securing full commitment of health care providers, conducting educational and awareness campaigns about generic drugs and generic drug substitution, and aligning incentive systems of the key stakeholders. CONCLUSIONS The majority of community pharmacists were supportive of generic drug substitution in general but not of the current implementation of the policy in Lebanon. Findings revealed implementation challenges at the provider, patient, and system level which are hindering attainment of the policy objectives. The key lessons derived from this study can be used for continuous improvement of the policy and its implementation.
Collapse
Affiliation(s)
- Fadi El-Jardali
- Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon
- Center for Systematic Reviews of Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | - Racha Fadlallah
- Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon
- Center for Systematic Reviews of Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | - Rami Z. Morsi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nour Hemadi
- Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon
- Center for Systematic Reviews of Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | | | - Magda Haj
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Suzan Khalil
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Youssef Saklawi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Diana Jamal
- Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon
| | - Elie A. Akl
- Center for Systematic Reviews of Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
21
|
Fadare JO, Adeoti AO, Desalu OO, Enwere OO, Makusidi AM, Ogunleye O, Sunmonu TA, Truter I, Akunne OO, Godman B. The prescribing of generic medicines in Nigeria: knowledge, perceptions and attitudes of physicians. Expert Rev Pharmacoecon Outcomes Res 2015; 16:639-650. [PMID: 26567041 DOI: 10.1586/14737167.2016.1120673] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Generic medicines have the same efficacy and safety as originators at lower prices; however, there are concerns with their utilization in Nigeria. Objective was to evaluate physicians' understanding and perception of generics. A questionnaire was administered among physicians working in tertiary healthcare facilities in four geo-political regions of Nigeria. Questionnaire response was 74.3% (191/257) among mainly males (85.9%). The mean knowledge score regarding generics was 5.3 (maximum of 9) with 36.6%, 36.1% and 27.2% having poor, average and good knowledge respectively. Cross-tabulation showed statistical significance (p = 0.047) with the duration of practice but not with position, subspecialty or sex. The majority of respondents did not believe that generic medicines are of lower quality than branded medicines. Therapeutic failure was a major concern in 82.7%, potentially discouraging the prescribing of generics, and a majority (63.9%) did not support generic substitution by pharmacists. Knowledge gaps were identified especially with the perception of generics, which need to be addressed.
Collapse
Affiliation(s)
- Joseph O Fadare
- a Department of Pharmacology , Ekiti State University , Ado-Ekiti , Nigeria
| | - Adekunle O Adeoti
- b Department of Medicine , Ekiti State University , Ado-Ekiti , Nigeria
| | - Olufemi O Desalu
- c Department of Medicine , University of Ilorin , Ilorin , Nigeria
| | - Okezie O Enwere
- d Department of Medicine , Imo State University , Orlu , Imo State , Nigeria
| | - Aliyu M Makusidi
- e Department of Medicine , Usman Danfodiyo University , Sokoto , Nigeria
| | - Olayinka Ogunleye
- f Clinical Pharmacology Unit, Department of Medicine , Lagos State University Teaching Hospital , Ikeja , Lagos , Nigeria.,g Department of Pharmacology and Therapeutics , Lagos State University College of Medicine , Ikeja , Lagos , Nigeria
| | | | - Ilse Truter
- i Drug Utilization Research Unit (DURU), Department of Pharmacy , Nelson Mandela Metropolitan University , Port Elizabeth 6031 , South Africa
| | - Onyinye O Akunne
- j Department of Pharmacology and Therapeutics , University of Ibadan, Ibadan , Nigeria
| | - Brian Godman
- k Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet , Karolinska University Hospital Huddinge , SE-141 86 , Stockholm , Sweden.,l Strathclyde Institute of Pharmacy and Biomedical Sciences , University of Strathclyde , Glasgow , UK
| |
Collapse
|
22
|
Colgan S, Faasse K, Martin LR, Stephens MH, Grey A, Petrie KJ. Perceptions of generic medication in the general population, doctors and pharmacists: a systematic review. BMJ Open 2015; 5:e008915. [PMID: 26671954 PMCID: PMC4679988 DOI: 10.1136/bmjopen-2015-008915] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To investigate negative perceptions about generic medicines and evaluate the proportions of lay people, doctors and pharmacists who hold these perceptions. DESIGN A systematic review of observational studies. DATA SOURCES MEDLINE, EMBASE, PsycInfo and Scopus. ELIGIBILITY CRITERIA Quantitative data from cross-sectional and prospective studies published in English after 1980, using self-report measures to evaluate perceptions about generic medicines, presented as percentages of the total sample assessed. RESULTS After screening 2737 articles, 52 articles were included in the final analysis. A high proportion of doctors, pharmacists and lay people had negative perceptions of generics. Lay people were significantly more likely to view generics as less effective than branded medication (35.6%, 95% CI 34.8% to 36.4%) compared to doctors (28.7%, 27.5% to 29.9%) and pharmacists (23.6%, 21.2% to 26.2%), p<0.0001. Pharmacists (33.4%, 31.0% to 35.9%) were significantly more likely to believe generics were of inferior quality compared to branded medication than were doctors (28.0%, 26.3% to 29.9%), p=0.0006, and lay people (25.1%, 24.2% to 26.0%), p<0.0001. Doctors believed generics caused more side effects than branded medication (24.4%, 22.2% to 26.9%), compared to pharmacists (17.6%, 15.3% to 20.1%) and lay people (18.8%, 17.8% to 19.8%), p<0.0001. Doctors (28.5%, 26.9% to 30.2%) and pharmacists (25.4%, 21.4% to 29.9%) had significantly more safety concerns about generics than did lay people (18.0%, 17.0% to 19.0%), p ≤ 0.0002. A greater proportion of lay people felt negatively about generic substitution (34.0%, 33.2% to 34.9%), compared to doctors (24.1%, 22.0% to 26.4%) and pharmacists (11.0%, 9.6% to 12.7%), p<0.0001. Rates of negative perceptions of generics do not appear to have changed substantially over time in the general population or among physician groups, p ≥ 0.431, but such negative beliefs show a decreasing trend in pharmacists over the study period, p=0.034. CONCLUSIONS A significant proportion of doctors, pharmacists and lay people hold negative perceptions of generic medicines. It is likely these attitudes present barriers to the wider use of generics.
Collapse
Affiliation(s)
- Sarah Colgan
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Kate Faasse
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Leslie R Martin
- Department of Psychology, La Sierra University, Riverside, California, USA
| | - Melika H Stephens
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Andrew Grey
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Keith J Petrie
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| |
Collapse
|
23
|
Bashaar M, Hassali MA, Saleem F. Community pharmacists' attitudes toward the quality and price of locally manufactured generic medicines in Kabul, Afghanistan. J Pharm Policy Pract 2015; 8:16. [PMID: 26078869 PMCID: PMC4467055 DOI: 10.1186/s40545-015-0037-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 04/17/2015] [Indexed: 11/13/2022] Open
Abstract
Objective To report the attitudes of community pharmacists in Kabul, Afghanistan, concerning the quality and price of locally manufactured medicines. Methods A cross-sectional descriptive study, involving a sample of 198 community pharmacists was conducted in Kabul city. Results With a response rate of 100%, most of the respondents 70.7% had 11–20 years experience working as a pharmacist. About 84.3% of the pharmacists dispensed imported generic medicines from Pakistan, Iran, India, and the UAE. Only 15.7% of pharmacists were dispensing locally produced generics from Ariana (i.e. a local pharmaceutical manufacturer). Exactly half of the pharmacists 50.0% reported that locally produced generics were equally safe and efficacious as the imported generics, while 70.7% of the respondents believed that the local manufacturers of generic products had reliable logistics and supply systems. However, 80.8% of respondents expressed concerns regarding their own credibility when stocking the medicines. Consequently, 80.3% of the sample only stocked well-advertised domestic generics, which were likely to be seen by consumers as more credible alternatives. Most of the respondents 82.8% were confident that the locally manufactured generics were cheaper than imported generics. Interestingly, 80.8% of the respondents favoured the establishment of a national brand substitution policy. Furthermore, 90.4% of the respondents believed that it was the responsibility of the Afghan regulatory authorities to educate pharmacists on the quality of domestic generics. Conclusion Although community pharmacists had a positive attitude towards the quality and affordability of locally manufactured medicines, due to lack of resources most of their medicines are imported. Despite their positivity towards the quality and price of generics, the community pharmacists only dispense them to a minimal degree, because of low local production levels among other reasons. The findings call for improvements in the local pharmaceutical industry in order to substitute imported medicines with local generics. The government must take firm steps to formulate and reinforce pharmaceutical pricing and brand substitution policies to help in controlling healthcare costs. Further research, especially a countrywide survey, is required.
Collapse
Affiliation(s)
- Mohammad Bashaar
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Pulau Pinang, Malaysia
| | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Pulau Pinang, Malaysia
| | - Fahad Saleem
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Pulau Pinang, Malaysia
| |
Collapse
|