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Brata C, Wibowo YI, Setiawan E, Halim SV, Razanah A, Sholikhah IM, Lailla PR, Rahmadini A, Putri IAERS, Schneider CR. Pharmacists' clinical decision making when responding to a self-medication request for a cough in a developing country. Res Social Adm Pharm 2024; 20:880-892. [PMID: 38762365 DOI: 10.1016/j.sapharm.2024.05.004] [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: 03/05/2023] [Revised: 12/23/2023] [Accepted: 05/07/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Some studies have reported that community pharmacies in developing countries, including Indonesia, provided sub-optimal advice when handling patient's self-medication request for cough. The reasons behind such advice, therefore, need to be investigated. OBJECTIVES To describe Indonesian pharmacists' clinical decision making when handling self-medication cases for a cough. METHODS An open-ended questionnaire consisting of two cough clinical vignettes (case 1: cough due to asthma worsening and case 2: cough as a symptom of common cold) were developed. Pharmacists were interviewed to provide recommendations and reasons for their recommendations for these scenarios. Content analysis was used to analyse participants' statements for the two scenarios. The number of participants who provided appropriate recommendations and reasons were then counted. RESULTS A total of 245 community pharmacists participated in the study. In the case of cough due to asthma worsening, recommending a product because the product was indicated to help with the symptoms was the most common recommendation and stated reason (40%). Appropriate recommendation (direct medical referral) with appropriate reasoning (indicating warning symptoms and/or making a symptom diagnosis) was provided by 25% participants. In the case of cough as a symptom of common cold, recommending products to help with the symptoms was also the most common recommendation and stated reason (53%). Appropriate recommendations (recommending product) with appropriate reasoning (providing product to treat the symptoms and/or indicating no warning symptoms and/or making a symptom diagnosis) was provided by 81% participants. CONCLUSION The ability of Indonesian community pharmacists to provide appropriate recommendations for cough self-medication requests is dependent on whether triage is required. The inability of most community pharmacists to differentiate between major and minor conditions may lead to serious health implications for patients and therefore educational interventions should be undertaken to improve community pharmacists' differential diagnostic skills for triage.
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Affiliation(s)
- Cecilia Brata
- Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, The University of Surabaya, Gedung FF Lantai 5, Jalan Raya Kalirungkut, Surabaya, Jawa Timur, 60293, Indonesia.
| | - Yosi Irawati Wibowo
- Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, The University of Surabaya, Gedung FF Lantai 5, Jalan Raya Kalirungkut, Surabaya, Jawa Timur, 60293, Indonesia
| | - Eko Setiawan
- Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, The University of Surabaya, Gedung FF Lantai 5, Jalan Raya Kalirungkut, Surabaya, Jawa Timur, 60293, Indonesia
| | - Steven Victoria Halim
- Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, The University of Surabaya, Gedung FF Lantai 5, Jalan Raya Kalirungkut, Surabaya, Jawa Timur, 60293, Indonesia
| | - Afina Razanah
- Faculty of Pharmacy, The University of Surabaya, Jalan Raya Kalirungkut, Surabaya, Jawa Timur, 60293, Indonesia
| | - Ima Mar'atus Sholikhah
- Faculty of Pharmacy, The University of Surabaya, Jalan Raya Kalirungkut, Surabaya, Jawa Timur, 60293, Indonesia
| | - Putri Rohmatu Lailla
- Faculty of Pharmacy, The University of Surabaya, Jalan Raya Kalirungkut, Surabaya, Jawa Timur, 60293, Indonesia
| | - Azilah Rahmadini
- Faculty of Pharmacy, The University of Surabaya, Jalan Raya Kalirungkut, Surabaya, Jawa Timur, 60293, Indonesia
| | | | - Carl R Schneider
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Pharmacy and Bank Building (A15) Science Road, NSW, 2006, Australia
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Febriyanti RM, Saefullah K, Susanti RD, Lestari K. Knowledge, attitude, and utilization of traditional medicine within the plural medical system in West Java, Indonesia. BMC Complement Med Ther 2024; 24:64. [PMID: 38287364 PMCID: PMC10826289 DOI: 10.1186/s12906-024-04368-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/20/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The concept of 'medical pluralism' has become more popular among scholars in applied health science and prevalent in societies where one medical system alone cannot adequately meet the health care needs of the entire population. METHODS The data collection is focused on the knowledge-belief-practice and the utilization of three medical systems in Kabupaten Bandung, West Java, Indonesia. Participants were purposively selected from households with at least one member experienced one of the listed diseases in the questionnaire. The extensive survey using a structured questionnaire has been undertaken to collect data on people's health care utilization behaviour. The dataset is further analyzed using multivariate analysis through non-canonical correlation, with the analytical data provided by Statistical Package for Social Sciences (SPSS). RESULTS With regards to the total utilization by patients, the traditional medical system presents as the dominant medical system in the research area, accounting for 59.3% (n = 419) of total utilization, followed by the modern medical system (33.0%, n = 233), and transitional medical system (7.7%, n = 54). This study identified that village category, illness, illness duration, occupation, belief in traditional medicine, knowledge of modern medicine, accessibility, cost, proximity to the medical service, and insurance have significant (χ2 = 0.000) relationship with the utilization of medical systems. The results of the multivariate analysis show that the block of the predisposing socio-demographic factors and the block of the predisposing psycho-social factors correlate strongly with the utilization of medical systems. CONCLUSIONS In general, people in Kabupaten Bandung, West Java, Indonesia seeks treatment from various sources, which in the context of the medical system, consists of the traditional, transitional, and modern medical system; therefore, it adopts the patterns of transcultural health care utilization. In terms of the knowledge, beliefs, and practices of traditional medicine in West Java, the inhabitants of the five research villages were commonly familiar with medicinal plants and speak profoundly about their knowledge of traditional medicine, which in the research area is perceived as accessible, efficacious, affordable and culturally appropriate with Sundanese community.
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Affiliation(s)
- Raden Maya Febriyanti
- Department of Biological Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jalan Raya Bandung-Sumedang KM. 21, Jatinangor, Sumedang West Java, 45363, Indonesia.
- Herbal Study Center, Universitas Padjadjaran, Jalan Raya Bandung-Sumedang KM. 21, Jatinangor, Sumedang West Java, 45363, Indonesia.
| | - Kurniawan Saefullah
- Faculty of Economy and Business, Universitas Padjadjaran, Jalan Raya Bandung-Sumedang KM. 21, Jatinangor, Sumedang West Java, 45363, Indonesia
| | - Raini Diah Susanti
- Faculty of Nursing, Universitas Padjadjaran, Jalan Raya Bandung-Sumedang KM. 21, Jatinangor, Sumedang West Java, 45363, Indonesia
| | - Keri Lestari
- Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Jalan Raya Bandung-Sumedang KM. 21, Jatinangor, Sumedang West Java, 45363, Indonesia
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Al-Omrani H, Marwah MK, Al-Whaib R, Mekkawy M, Shokr H. Patterns of Drug Utilization and Self-Medication Practices: A Cross Sectional Study. PHARMACY 2023; 11:183. [PMID: 38133458 PMCID: PMC10747327 DOI: 10.3390/pharmacy11060183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/12/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Self-medication (SM) is a growing phenomenon worldwide that has recently been classified as one of the most serious public health problems. SM can result in an incorrect self-diagnosis, inappropriate treatment, potential adverse reactions, interactions, and the masking of more sinister disease. OBJECTIVES To assess the prevalence of SM practices amongst healthcare professionals and the general population in Saudi Arabia and to identify the sociodemographic contributing factors to this practice. METHODS A total of 540 participants were enrolled in this study. Participants were asked to complete the study questionnaire comprising two sections to gather demographic information and to collect data regarding SM practice. RESULTS The prevalence of SM practice among the study participants was 78.6%, and it was the highest among the middle age groups of (21-40 years) 82% compared to the younger and older age groups. The observed prevalence was higher in the female participants (53.7%) and those who live alone. Type of education did not affect the attitude of SM (p = 0.374); however, level of education strongly affected the prevalence of the SM, with higher incidence among university graduates (p < 0.001). Analgesics with antipyretics properties were the most self-medicated drugs. Patients considering their illnesses minor was the main reason behind the high prevalence of this practice. Among healthcare professions the highest prevalence of SM was found among pharmacists (95%), followed by physicians, nurses, and other medical practitioners. CONCLUSION The general population should be better educated and made conscious about the consequences, risks, and side effects of SM. Awareness campaigns may prove to be useful in this matter, allowing the patient to consider the appropriateness of this practice. Individuals in the age group of 21-40 years, females, and those who live alone should be considered priority target populations in the design and implementation of SM awareness projects.
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Affiliation(s)
- Hamod Al-Omrani
- Pharmacy Practice Department, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa 31982, Saudi Arabia
| | - Mandeep Kaur Marwah
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
| | - Razan Al-Whaib
- Pharmacy Practice Department, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa 31982, Saudi Arabia
| | - Mohammed Mekkawy
- High Institute of Public Health, Alexandria University, Alexandria 21526, Egypt
| | - Hala Shokr
- Pharmacy Division, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
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Marjadi B, Alfian R, Susanto Y, Tjandra L, Pratama ANW, Schneider C. Pharmacists' continuing professional development for non-communicable diseases management: A consensus study. Res Social Adm Pharm 2022; 18:3964-3973. [PMID: 35864038 DOI: 10.1016/j.sapharm.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Pharmaceutical care for non-communicable diseases (NCD) in Indonesia needs improvement especially in provinces like Kalimantan Selatan (Kalsel) with increasing NCD prevalence. This research explored possible improvements for Kalsel pharmacists NCD Continuing Professional Development (CPD) programmes. OBJECTIVES The study aims to identify Kalsel pharmacists' engagement with, experiences of, and expectations for NCD-focused CPD activities, and CPD stakeholders' views on these expectations. METHODS This sequential mixed-methods study used a quantitative survey to map Kalsel pharmacists' CPD engagement and preferences. The survey findings, and Kalsel pharmacists' knowledge and skills in NCD management, were further explored in four geographically-diverse focus group discussions (FGDs). Triangulated findings from the survey and FGDs were presented to pharmacist CPD stakeholders in a modified Nominal Group Technique (NGT) discussion, resulting in a prioritised list of CPD activities and allocation of local leadership for each activity. RESULTS The survey response rate was 51% (249/490) with fair representation of the geographic spread. CPD sessions were seen as a social event to network with colleagues (34%) and improve knowledge (31%). Major hindrances for participation were work commitments (25%) and travel needs (22%). Most participants (64%), especially the more senior, preferred explicitly interactive CPD formats (adjusted odds ratio 0.94 for each additional year from graduation; 95% confidence interval 0.89-0.99; p = 0.036). The FGDs identified challenges in managing NCD, strengths and gaps in NCD knowledge, and preferences for NCD CPD. The modified NGT produced 12 actions which five major stakeholders agreed to lead. CONCLUSIONS An explicitly interactive NCD CPD programme based on a community of practice model and supported by blended learning is likely to be most effective for pharmacists in the Kalimantan Selatan province of Indonesia. A co-designed multi-stakeholder systems-based approach to CPD programme, as used in this study, is likely to increase the engagement and success of the programme.
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Affiliation(s)
- Brahmaputra Marjadi
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia; Faculty of Medicine, Universitas Wijaya Kusuma Surabaya, Jalan Dukuh Kupang XXV/54, Surabaya, 60225, Indonesia.
| | - Riza Alfian
- Sekolah Tinggi Ilmu Kesehatan ISFI Banjarmasin, Jl. Flamboyan III No.7C, Banjarmasin, Kalimantan Selatan, 70123, Indonesia.
| | - Yugo Susanto
- Sekolah Tinggi Ilmu Kesehatan ISFI Banjarmasin, Jl. Flamboyan III No.7C, Banjarmasin, Kalimantan Selatan, 70123, Indonesia.
| | - Lusiani Tjandra
- Faculty of Medicine, Universitas Wijaya Kusuma Surabaya, Jalan Dukuh Kupang XXV/54, Surabaya, 60225, Indonesia.
| | | | - Carl Schneider
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, N517, Pharmacy and Bank Building A15, NSW, 2006, Australia.
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Yellappa V, Bindu H, Rao N, Narayanan D. Understanding dynamics of private tuberculosis pharmacy market: a qualitative inquiry from a South Indian district. BMJ Open 2022; 12:e052319. [PMID: 35074813 PMCID: PMC8788189 DOI: 10.1136/bmjopen-2021-052319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES In India, retail private pharmacists (RPPs) are often patients' first point of contact for diseases, including tuberculosis (TB). We assessed the factors influencing RPPs' referral of patients with chest symptoms to the National TB Elimination Programme (NTEP) and the way business is carried out with reference to TB drugs. DESIGN We conducted semistructured interviews with a purposive sample of 41 RPPs in a South Indian district between May and October 2013. Data were collected from urban areas (21 RPPs) and rural areas (20 RPPs) employing the principle of data saturation. Data were analysed thematically using NVivo V.9. RESULTS Knowledge and compliance of RPPs regarding TB symptoms and regulatory requirements were found to be poor. The RPPs routinely dispensed medicines over the counter and less than half of the respondents had pharmacy qualifications. None of them had received TB-related training, yet half of them knew about TB symptoms. Practice of self-referrals was common particularly among economically poorer populations who preferred purchasing medicines over the counter based on RPPs' advice. Inability of patients with TB to purchase the full course of TB drugs was conspicuous. Rural RPPs were more likely to refer patients with TB symptoms to the NTEP compared with urban ones who mostly referred such clients to private practitioners (PPs). Reciprocal relationships between the RPPs, PPs, medical representatives and the prevalence of kickbacks influenced RPPs' drug-stocking patterns. PPs wielded power in this nexus, especially in urban areas. CONCLUSION India hopes to end TB by 2025. Our study findings will help the NTEP to design policy and interventions to engage RPPs in public health initiatives by taking cognisance of symbiotic relationships and power differentials that exist between PPs, RPPs and medical representatives. Concurrently, there should be a strong enforcement mechanism for existing regulatory norms regarding over-the-counter sales and record keeping.
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Affiliation(s)
- Vijayashree Yellappa
- Health Service Delivery, Institute of Public Health Bengaluru, Bangalore, Karnataka, India
- PPP Division, NITI Aayog, Delhi, Delhi, India
| | - Himabindu Bindu
- Health Service Delivery, Institute of Public Health Bengaluru, Bangalore, Karnataka, India
| | - Neethi Rao
- Health Service Delivery, Institute of Public Health Bengaluru, Bangalore, Karnataka, India
| | - Devadasan Narayanan
- Health Service Delivery, Institute of Public Health Bengaluru, Bangalore, Karnataka, India
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Ferdiana A, Liverani M, Khan M, Wulandari LPL, Mashuri YA, Batura N, Wibawa T, Yeung S, Day R, Jan S, Wiseman V, Probandari A. Community pharmacies, drug stores, and antibiotic dispensing in Indonesia: a qualitative study. BMC Public Health 2021; 21:1800. [PMID: 34620152 PMCID: PMC8499417 DOI: 10.1186/s12889-021-11885-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inappropriate dispensing of antibiotics at community pharmacies is an important driver of antimicrobial resistance (AMR), particularly in low- and middle-income countries. Thus, a better understanding of dispensing practices is crucial to inform national, regional, and global responses to AMR. This requires careful examination of the interactions between vendors and clients, sensitive to the context in which these interactions take place. METHODS In 2019, we conducted a qualitative study to examine antibiotic dispensing practices and associated drivers in Indonesia, where self-medication with antibiotics purchased at community pharmacies and drug stores is widespread. Data collection involved 59 in-depth interviews with staff at pharmacies and drug stores (n = 31) and their clients (n = 28), conducted in an urban (Bekasi) and a semi-rural location (Tabalong) to capture different markets and different contexts of access to medicines. Interview transcripts were analysed using thematic content analysis. RESULTS A common dispensing pattern was the direct request of antibiotics by clients, who walked into pharmacies or drug stores and asked for antibiotics without prescription, either by their generic/brand name or by showing an empty package or sample. A less common pattern was recommendation to use antibiotics by the vendor after the patient presented with symptoms. Drivers of inappropriate antibiotic dispensing included poor knowledge of antibiotics and AMR, financial incentives to maximise medicine sales in an increasingly competitive market, the unintended effects of health policy reforms to make antibiotics and other essential medicines freely available to all, and weak regulatory enforcement. CONCLUSIONS Inappropriate dispensing of antibiotics in community pharmacies and drug stores is the outcome of complex interactions between vendors and clients, shaped by wider and changing socio-economic processes. In Indonesia, as in many other LMICs with large and informal private sectors, concerted action should be taken to engage such providers in plans to reduce AMR. This would help avert unintended effects of market competition and adverse policy outcomes, as observed in this study.
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Affiliation(s)
- Astri Ferdiana
- Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.,Faculty of Medicine, Universitas Mataram, Mataram, Indonesia
| | - Marco Liverani
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK. .,School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan. .,Faculty of Public Health, Mahidol University, Bangkok, Thailand.
| | - Mishal Khan
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.,Aga Khan University, Karachi, Pakistan
| | - Luh Putu Lila Wulandari
- The Kirby Institute, University of New South Wales, Sydney, Australia.,Faculty of Medicine, Universitas Udayana, Bali, Indonesia
| | - Yusuf Ari Mashuri
- Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.,Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Neha Batura
- Institute for Global Health, University College London, London, UK
| | - Tri Wibawa
- Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.,Department of Microbiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Shunmay Yeung
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard Day
- St Vincent's Clinical School, University of New South Wales, Sydney, Australia
| | - Stephen Jan
- The George Institute for Global Health, Sydney, Australia
| | - Virginia Wiseman
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.,The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Ari Probandari
- Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.,Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
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Brata C, Halim SV, Setiawan E, Presley B, Wibowo YI, Schneider CR. The competency of Indonesian pharmacy students in handling a self-medication request for a cough: a simulated patient study. Pharm Pract (Granada) 2021; 19:2269. [PMID: 34035868 PMCID: PMC8118600 DOI: 10.18549/pharmpract.2021.2.2269] [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: 01/02/2021] [Accepted: 04/11/2021] [Indexed: 11/14/2022] Open
Abstract
Background Cough is a common symptom for which people frequently present to community pharmacies. Previous articles from developing countries have shown that the provision of self-medication consultation for cough in community pharmacies were suboptimal, with knowledge deficiency being a contributing factor. However, little is known regarding the ability of pharmacy students in handling self-medication consultations in developing countries. Objectives To measure the competency of Indonesian pharmacy students in providing self-medication consultations for patients with chronic cough and to identify factors associated with the provision of appropriate advice. Method This study is a cross-sectional study. A simulated patient method using a product and a symptom-based request of chronic cough was used in students from a pharmacy school in Indonesia. The nature and amount of information gathered and advice provided by pharmacy students were noted and audio-recorded. A logistic regression analysis was performed to identify factors associated with the provision of appropriate advice. Results The information gathered by participating students was not comprehensive. The most common types of information gathered were related to the nature and duration of the cough. Information relating to accompanying symptoms, medications, and allergies was gathered in less than 60% of the participating students for both product and symptom based scenarios. The appropriate advice of direct medical referral was provided in 54% and 56% of the 183 participating students for the product and symptom-based request scenarios respectively. Asking about symptom duration and prior medical conditions were positively associated with the provision of appropriate advice in the symptom and product based requests respectively. Conclusion Student competency in self-medication consultation for chronic cough needs to be improved. Appropriate information-gathering is a predictor of appropriate advice. Further qualitative research identifying factors affecting students' competence in providing self-medication consultation is required, so that suitable interventions are developed and implemented.
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Affiliation(s)
- Cecilia Brata
- PhD. Lecturer. Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, University of Surabaya. Surabaya (Indonesia).
| | - Steven V Halim
- Mpharm. Lecturer. Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, University of Surabaya. Surabaya (Indonesia).
| | - Eko Setiawan
- MSc (Clin Pharm). Lecturer. Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, University of Surabaya. Surabaya (Indonesia).
| | - Bobby Presley
- Mpharm. Lecturer. Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, University of Surabaya. Surabaya (Indonesia).
| | - Yosi I Wibowo
- PhD. Senior Lecturer. Centre of Medicine Information and Pharmaceutical Care, Faculty of Pharmacy, University of Surabaya. Surabaya (Indonesia).
| | - Carl R Schneider
- PhD. Senior Lecturer. School of Pharmacy, Faculty of Medicine and Health, University of Sydney. Sydney (Australia).
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Seiberth JM, Moritz K, Herrmann NS, Bertsche T, Schiek S. What influences the information exchange during self-medication consultations in community pharmacies? A non-participant observation study. Res Social Adm Pharm 2021; 18:2444-2456. [PMID: 33840622 DOI: 10.1016/j.sapharm.2021.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 03/21/2021] [Accepted: 03/27/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although pharmaceutical staff consider guideline-compliant information exchange during self-medication consultations as crucial, they have not fully integrated it into practice. It is unclear what prevents pharmaceutical staff from implementing their positive intentions into their actual everyday practice. To improve the information exchange during the current consultation practice, a deeper understanding of its implementation is needed. OBJECTIVES The aim was to evaluate the factors influencing information exchange during self-medication consultations in German community pharmacies. METHODS We performed a non-participant observation of real-life consultations with post-consultation interviews of pharmaceutical staff in 10 pharmacies. The information exchanged during self-medication consultations was evaluated via 7 guideline-recommended information parameters in 2 stages of information exchange: (a) 'information gathering' and (b) 'provision of information'. Directly after each observed consultation, pharmaceutical staff's opinion about the consultation, the customer's interest and their own performance was questioned. Factors associated with the observed extent of information exchange were analysed by Poisson regression analysis. RESULTS In the 379 self-medication consultations with 46 pharmaceutical staff members, 454 different customer enquiries were addressed, and 483 medications were dispensed. In median, 2 predefined information parameters (First-/Third quartile: 1/4) were fulfilled during an enquiry and 2 parameters (First-/Third quartile: 1/3) were fulfilled for a dispensed medication. Pharmaceutical staff were satisfied with 85% of their consultations and perceived 76% of them as easy to handle. In both information stages, information exchange increased when 'customers were perceived to be interested in counselling' (p < 0.001) and decreased when customers had a 'specific medication request' (p < 0.001). CONCLUSIONS Information exchange in pharmacies needs to be better integrated into daily practice. Strategies to encourage information exchange should also include pharmaceutical staffs' perception of their own counselling technique. Ongoing patient-centred trainings should facilitate strategies to engage uninterested customers or costumers with specific medication requests in consultations.
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Affiliation(s)
- Jasmin Mina Seiberth
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany; Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
| | - Katharina Moritz
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany; Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
| | - Nia Sophie Herrmann
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany; Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
| | - Thilo Bertsche
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany; Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany.
| | - Susanne Schiek
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany; Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
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Meilianti S, Smith F, Ernawati DK, Pratita RN, Bates I. A country-level national needs assessment of the Indonesian pharmacy workforce. Res Social Adm Pharm 2021; 17:1989-1996. [PMID: 33766504 DOI: 10.1016/j.sapharm.2021.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/06/2021] [Accepted: 03/07/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Conducting a systematic country-level workforce needs-assessment is a way to develop coherent strategic and justifiable workforce planning. OBJECTIVE(S) This article describes a country-level needs-assessment process using a systematic approach (via the FIP Development Goals (FIP DGs) workforce element) as an analytical framework. The needs-assessment aimed to prioritise gaps toward transforming the pharmacy workforce as a prelude to practice and pharmaceutical services reform in Indonesia. METHODS The needs assessment consisted of three stages: needs identification, needs analysis, and needs prioritisation. The needs (workforce development gaps) were defined as the discrepancies between the perceived workforce challenges and the existing national workforce development projects. Interviews or group discussions were conducted to gather the workforce challenges of individual pharmacists. A structured workshop was conducted to identify workforce challenges and existing organisations' projects, with main stakeholders contributing to pharmacists' development in Indonesia. Perceived challenges findings and identified national workforce projects were mapped to the FIP DGs workforce element. The needs prioritisation was conducted by comparing the proportional mapping to the FIP DGs workforce element. RESULTS There were forty-three individual pharmacists and 7 principal stakeholder categories that provided information related to perceived workforce challenges; thirty national projects were identified from stakeholders. While this study identified perceived challenges with workforce "competency development" and "pharmacy workforce intelligence," there were no active ongoing national projects mapped to those goals. The framework mapping analysis showed there are workforce development gaps centred on "competency development" initiatives, "advanced and specialist development" initiatives, and strategic pharmacy workforce intelligence data gathering. Additionally, there were policy gaps with initiatives for strengthening "working with others" and a lack of clarity on infrastructure for early-career training strategies and workforce impact. CONCLUSIONS This study prioritises the gaps in developing pharmacists in Indonesia. This process could be used in conducting needs assessment of pharmacy workforce development in other Low and Middle-Income Countries (LMICs).
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Affiliation(s)
- Sherly Meilianti
- UCL School of Pharmacy, 29-39 Brunswick Square, Bloomsbury, London WC1N 1AX, UK.
| | - Felicity Smith
- UCL School of Pharmacy, 29-39 Brunswick Square, Bloomsbury, London WC1N 1AX, UK.
| | - Desak Ketut Ernawati
- Indonesian Pharmacists Association, Wijaya Kusuma No. 17, Jatipulo, West Jakarta, Jakarta, 11430, Indonesia; Department of Pharmacology and Therapy, Universitas Udayana, Denpasar, Bali, 80234, Indonesia.
| | - Rasta Naya Pratita
- Indonesian Pharmacists Association, Wijaya Kusuma No. 17, Jatipulo, West Jakarta, Jakarta, 11430, Indonesia.
| | - Ian Bates
- UCL School of Pharmacy, 29-39 Brunswick Square, Bloomsbury, London WC1N 1AX, UK.
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Suryaputra G, Setiadi AP, Wibowo YI, Setiawan E, Sunderland B. Counselling practices in an East Javan district, Indonesia: what information is commonly gathered by pharmacy staff? JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2021. [DOI: 10.1093/jphsr/rmab001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract
Counselling by pharmacy staff plays a key role in ensuring the quality use of medications in community settings. Information gathering is the first step and an essential part of counselling. Yet, data on information gathering during counselling in Indonesia is lacking.
Objective
To identify pharmacy staff’s practice of counselling and information gathered during counselling in an East Javan district, Indonesia.
Methods
A survey questionnaire was conducted in community-based health facilities in the district (i.e. 3 hospital outpatient clinics, 69 community pharmacies and 24 Community Health Centres [CHCs]); one health facility was represented by one pharmacy staff. Quantitative content analysis was used to summarise data regarding information gathering.
Key findings
Sixty-six pharmacy staff responded, giving a 69% response rate. Almost all staff reported providing counselling; those at CHCs and outpatient clinics mostly provided prescription medicine counselling (95.5% and 100.0%, respectively), while those at community pharmacies mostly provided non-prescription medicine counselling (symptom-based versus product-based requests: 94.9% versus 71.8%, respectively). For non-prescription counselling, the most frequent information gathered was details of symptoms (symptoms-based versus product-based requests: 97.3% versus 75.0%, respectively). While for prescription medication counseling, pharmacy staff mostly asked the patient’s identity (76.2%). Less than 20% of the pharmacy staff for non-prescription/prescription medication counselling gathered information on concurrent medications or history of allergies or adverse drug reactions.
Conclusions
Pharmacy staff in these Indonesian settings provided prescription/non-prescription counselling to some extent. Improved information gathering skills are required for effective counselling, especially for prescription medications, thus ensuring rational drug use among Indonesians.
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Affiliation(s)
- Grace Suryaputra
- Master of Pharmacy Programme, Faculty of Pharmacy, Universitas Surabaya, Surabaya, East Java, Indonesia
| | - Adji Prayitno Setiadi
- Centre for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, Universitas Surabaya, Surabaya, East Java, Indonesia
| | - Yosi Irawati Wibowo
- Centre for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, Universitas Surabaya, Surabaya, East Java, Indonesia
| | - Eko Setiawan
- Centre for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, Universitas Surabaya, Surabaya, East Java, Indonesia
| | - Bruce Sunderland
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Perth, Australia
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Torres NF, Solomon VP, Middleton LE. Pharmacists' practices for non-prescribed antibiotic dispensing in Mozambique. Pharm Pract (Granada) 2020; 18:1965. [PMID: 32922571 PMCID: PMC7470239 DOI: 10.18549/pharmpract.2020.3.1965] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 08/09/2020] [Indexed: 12/15/2022] Open
Abstract
Background Antibiotics are the most frequently used medicines worldwide with most of the countries defining these as prescription-only medicines. Though, dispensing non-prescribed antibiotics represent one of the chief causal factors to the irrational use of antibiotics that paves the way to the development of antimicrobial resistance. Objective We aimed at describing the practices and the enablers for non-prescribed antibiotic dispensing in Maputo city, Mozambique. Methods A qualitative study was conducted, between October 2018 and March 2019, in nine private pharmacies randomly selected across Maputo city. Eighteen pharmacists were contacted and seventeen enrolled through snowball sampling. In-depth interviews were conducted, audiotaped, and transcribed verbatim. Transcripts were coded and analysed though thematic analysis with guidelines from Braun and Clark. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist by (Tong, 2007) was performed. Results Out of seventeen, fifteen pharmacists admitted non-prescribed dispensing of antibiotics. Common antibiotic dispensing practices included; dispensing without prescription, without asking for a brief clinical history of patients, without clear explanation of the appropriate way of administering, without advising on the side effects. Reasons for non-prescribed antibiotic dispensing are linked to patients' behaviour of demanding for non-prescribed antibiotics, to the patients expectations and beliefs on the healing power of antibiotics, to the physicians' prescribing practices. Other reasons included the pressure for profits from the pharmacy owners, the fragile law enforcement, and absence of accountability mechanisms. Conclusions The practices of non-prescribed antibiotic dispensing characterize the 'daily life' of the pharmacists. On the one hand, the patient's demand for antibiotics without valid prescriptions, and pharmacist's wish to assist based on their role in the pharmacy, the pressure for profits and on the understanding of the larger forces driving the practices of self-medication with antibiotics - rock. On the other hand, pharmacists are aware of the legal status of antibiotics and the public health consequences of their inappropriate dispensing practices and their professional and ethical responsibility for upholding the law - hard place. Highlighting the role of pharmacists and their skills as health promotion professionals is needed to optimizing antibiotic dispensing and better conservancy in Mozambique.
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Affiliation(s)
- Neusa F Torres
- Higher Institute for Health Sciences (ISCISA). Maputo (Mozambique).
| | - Vernon P Solomon
- MSc (Clin Psychol). Discipline of Pharmaceutical Sciences School of Health Sciences, University of KwaZulu Natal. Durban (South Africa).
| | - Lyn E Middleton
- Phd (Nurs & Educ). Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu Natal. Durban (South Africa).
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Iramiot JS, Kajumbula H, Bazira J, Kansiime C, Asiimwe BB. Antimicrobial resistance at the human-animal interface in the Pastoralist Communities of Kasese District, South Western Uganda. Sci Rep 2020; 10:14737. [PMID: 32895433 PMCID: PMC7477235 DOI: 10.1038/s41598-020-70517-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/09/2020] [Indexed: 12/17/2022] Open
Abstract
Intensive usage of antimicrobials in the management of animal diseases leads to selection for resistance among microorganisms. This study aimed to assess antimicrobial use and to describe factors associated with the transmission of antimicrobial resistance between humans and animals in pastoralist communities of Kasese district. A mixed-methods approach was employed in this study. Rectal swabs were collected from the participants and cattle and transported in Carry-Blaire transport medium to the laboratory within 24 h of collection for culture and sensitivity to confirm carriage of multi-drug resistant bacteria. In-depth interviews were conducted among veterinary officers, veterinary drug vendors, human health facility in-charges in both public and private health facilities, and operators of human pharmacies and drug shops. Carriage of multi-drug resistant bacteria among humans was 88 (93%) and 76(80%) among cattle. Consumption of lakeshore water and carriage of multi-drug resistant bacteria in cattle were associated with carriage of multi-drug resistant bacteria in the human population. The prevalence of multi-drug resistance among organisms Isolated from both humans and animals was high. There is a high likelihood of transmission of multi-drug resistance between humans and animals.
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Affiliation(s)
- Jacob Stanley Iramiot
- Department of Medical Microbiology, College of Health Sciences, Makerere University School of Biomedical Sciences, P.O Box 7072, Kampala, Uganda
- Department of Microbiology and Immunology, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Henry Kajumbula
- Department of Medical Microbiology, College of Health Sciences, Makerere University School of Biomedical Sciences, P.O Box 7072, Kampala, Uganda
| | - Joel Bazira
- Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Catherine Kansiime
- Department of Medical Microbiology, College of Health Sciences, Makerere University School of Biomedical Sciences, P.O Box 7072, Kampala, Uganda
| | - Benon B. Asiimwe
- Department of Medical Microbiology, College of Health Sciences, Makerere University School of Biomedical Sciences, P.O Box 7072, Kampala, Uganda
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Hermansyah A, Wulandari L, Kristina SA, Meilianti S. Primary health care policy and vision for community pharmacy and pharmacists in Indonesia. Pharm Pract (Granada) 2020; 18:2085. [PMID: 32774531 PMCID: PMC7392514 DOI: 10.18549/pharmpract.2020.3.2085] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The practice of community pharmacy in low and middle-income countries, including in Indonesia, is often described as in the state of infancy with several intractable barriers that have been substantially and continuously hampering the practice. Such description might be valid in highlighting how pharmacy is practiced and the conditions within and beyond community pharmacy organizations. Therefore, it is not surprising that the concept of integrating community pharmacy into the primary care system may not be considered in the contemporary discourse despite the fact that community pharmacy has been operating within communities for years. However, in the case of Indonesia, we argue that changes in the health care system within the past decade particularly with the introduction of the universal health coverage (UHC) in 2014, may have significantly amplified the role of pharmacists. There is good evidence which highlights the contribution of pharmacist as a substantial health care element in primary care practice. The initiative for employing pharmacist, identified in this article as primary care pharmacist, in the setting of community health center [puskesmas] and the introduction of affiliated or contracted community pharmacy under the UHC have enabled pharmacist to work together with other primary care providers. Moreover, government agenda under the “Smart Use of Medicines” program [Gema Cermat] recognizes pharmacists as the agent of change for improving the rational use of medicines in the community. Community pharmacy is developing, albeit slowly, and is able to grasp a novel position to deliver pharmacy-related primary care services to the general public through new services, for example drug monitoring and home care. Nevertheless, integrating community pharmacy into primary care is relatively a new notion in the Indonesian setting, and is a challenging process given the presence of barriers in the macro, meso- and micro-level of practice.
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Affiliation(s)
- Andi Hermansyah
- Faculty of Pharmacy, Airlangga University. Surabaya (Indonesia).
| | - Luh Wulandari
- Faculty of Medicine, Udayana University. Bali (Indonesia).
| | - Susi A Kristina
- Faculty of Pharmacy, University Gadjah Mada. Yogyakarta (Indonesia).
| | - Sherly Meilianti
- Department of practice and policy, School of Pharmacy, University College London. London (United Kingdom).
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Simon B, Kazaura M. Prevalence and Factors Associated with Parents Self-Medicating Under-Fives with Antibiotics in Bagamoyo District Council, Tanzania: a Cross-Sectional Study. Patient Prefer Adherence 2020; 14:1445-1453. [PMID: 32884246 PMCID: PMC7443408 DOI: 10.2147/ppa.s263517] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/25/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Self-medication with antibiotics (SMA) is a global problem. This extends to medication of under-fives by their parents. In particular, there is currently insufficient information for this problem. PURPOSE To determine the proportion and factors associated with medication of under-fives with antibiotics by their parents. MATERIALS AND METHODS A cross-sectional study among parents/caregivers of under-fives in 30 hamlets/streets of Bagamoyo District Council, in Tanzania was conducted between July and August, 2019. Respondents were the under-fives' parents/caregivers aged at least 18 years selected from households using probability proportional to a size cluster-sampling method. Respondents were required to report whether or not the under-fives had been unwell within the past 12 months and to describe the type or specific name of any medicine administered to their child. We used descriptive and analytical procedures to analyze the data. RESULTS The study included 730 parents/caregivers of under-fives. Their mean age was 32.2 (SD=7.4) years. The majority 668 (91.5%) were biological mothers and 574 (78.6%) having completed primary education. The proportion of parental SMA to under-fives was 47.7% (95% CI=43.7, 51.8). Knowledge on the appropriate use of antibiotics among parents was low. The most commonly used antibiotic was amoxicillin, 181 (62.0%). Independent factors associated with parental SMA to under-fives were average household income, distance to the nearest health facility, knowledge about use of antibiotics and the parent/caregiver's awareness of prescription-only medicines (POMs). CONCLUSION Since the prevalence of SMA by parents to under-fives in Bagamoyo District is high, there is a need for health systems to enhance those measures that would control the sale of antibiotics without prescriptions. In addition, more than half of all study participants have a minimal understanding of the use of antibiotics and are unaware of POMs. Findings indicate a need to have routine continuous health education at the community level about the use of antibiotics.
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Affiliation(s)
| | - Method Kazaura
- Department of Epidemiology/Biostatistics, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
- Correspondence: Method Kazaura Department of Epidemiology/Biostatistics, Muhimbili University of Health and Allied Sciences, PO Box 65015, Dar Es Salaam, TanzaniaTel +255-784-767717 Email
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Karimy M, Rezaee-Momtaz M, Tavousi M, Montazeri A, Araban M. Risk factors associated with self-medication among women in Iran. BMC Public Health 2019; 19:1033. [PMID: 31370891 PMCID: PMC6676788 DOI: 10.1186/s12889-019-7302-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 07/10/2019] [Indexed: 01/15/2023] Open
Abstract
Background Self-medication is a public health concern that may create several problems such as increase in drug resistance, raise in drug use per capita, and creating side effects. This study was conducted to determine predictors of self-medication based on the theory of planned behavior (TPB) among the Iranian women. Methods This was a cross sectional study. A sample of married women completed a validated, anonymous, self-administered questionnaire. The questionnaire included items on demographic variables, knowledge, and TPB structures, and the checklist of women’s self-medication practices. The study was conducted in six urban health centers of Shush and Zarandieh in Iran during January to July 2016. Data were analyzed using SPSS 23.0 applying t-test and logistic regression. Results A total of 360 women took part in the study. The results showed that 76% of women had a history of self-medication and 98.9% stored drugs at home. The most important reasons for self-medication were perceived self-medication harmless (41%), having history of a disease (35.5%), and availability of medications at home (34%). The most frequent diseases for self-medication were fatigue, weakness, and anxiety (24%), and fever (20%). The results obtained form logistic regression analysis indicated that age, place of residence, education level, health insurance status, as well as all constructs of the TPB were significant predictors for self-medication. Conclusion The findings indicated that the prevalence of self-medication among Iranian women was high. Since women have important role in shaping the family health, the issue of high prevalence among this population should be considered as a serious problem in Iran. In this regard, it is recommended to consider factors affecting self-medication among women to reduce this health threatening factors.
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Affiliation(s)
- Mahmood Karimy
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Majed Rezaee-Momtaz
- Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmoud Tavousi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Ali Montazeri
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Marzieh Araban
- Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. .,Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Brata C, Schneider CR, Marjadi B, Clifford RM. The provision of advice by pharmacy staff in eastern Indonesian community pharmacies. Pharm Pract (Granada) 2019; 17:1452. [PMID: 31275500 PMCID: PMC6594425 DOI: 10.18549/pharmpract.2019.2.1452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/12/2019] [Indexed: 11/19/2022] Open
Abstract
Background: Indonesian community pharmacies hold a strategic position from which to
promote the rational use of medicines by providing appropriate advice for
patients requesting self-medication. To date, published studies related to
the provision of advice in Indonesian community pharmacies are limited and
have been conducted only in more developed western Indonesia. No studies
have been undertaken in eastern Indonesia, which is less developed than and
culturally different from the western region. Objectives: This paper aims to: (1) describe the types and amount of advice provided by
pharmacy staff for three scenarios in a patient simulation study and for two
scenarios in pharmacy staff interviews; and (2) ascertain the frequency of
appropriate advice given in response to the scenarios. Methods: A patient simulation study was conducted at community pharmacies in an
eastern Indonesian provincial capital. Four weeks after completing a patient
simulation study, structured interviews with pharmacy staff were conducted.
Two cough scenarios and one diarrhoea scenario were developed for the
patient simulation study. Meanwhile, two scenarios (an ACE inhibitor-induced
cough and a common cough and cold) were developed for pharmacy staff
interviews. The types and amount of advice provided by pharmacy staff were
recorded on paper and assessed for its appropriateness. The determination of
appropriate advice was based on the literature and by consensus of two
Indonesian experts. Results: In patient simulation, the most common type of advice provided in all
scenarios was product recommendations. In interviews, medical referrals and
recommending cough and cold medicine were the most common types of advice
provided for ACE inhibitor-induced cough and common cough and cold scenarios
respectively. Appropriate advice was provided in less than 0.5% in
the patient simulation study, but two-third of participants in the
interviews responded to the scenarios appropriately. Conclusions: Pharmacy staff did not provide appropriate advice in practice, although they
may have adequate knowledge. A contributing factor was insufficient
information gathered in patient encounters. Optimising information-gathering
practice by pharmacy staff is needed.
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Affiliation(s)
- Cecilia Brata
- Centre of Medicine Information and Pharmaceutical Care, University of Surabaya, Surabaya (Indonesia).
| | - Carl R Schneider
- Faculty of Pharmacy, University of Sydney. Sydney, NSW (Australia).
| | | | - Rhonda M Clifford
- School of Medicine and Pharmacology, University of Western Australia. Perth, WA (Australia).
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Fereidouni Z, Kameli Morandini M, Najafi Kalyani M. Experiences of self-medication among people: a qualitative meta-synthesis. ACTA ACUST UNITED AC 2019; 27:83-89. [PMID: 30680607 DOI: 10.1007/s40199-019-00244-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/15/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Self-medication is one of the major health-related problems in the world, which causes many problems for people and health systems. No comprehensive qualitative meta-synthesis has been done to understand the perceptions and experiences of self-medication among people. OBJECTIVES This study aimed to analyze, re-interpret, and synthesize the existing qualitative studies on perceptions and experiences of self-medication among people around the world. METHODS In this meta-synthesis, all published qualitative studies in PubMed, Scopus, CINAHL, and Web of Science databases were searched in May 2018. A total of 543 articles were screened in the primary stage and finally five articles that met the inclusion criteria were included in the meta-synthesis. The included studies were analyzed using Noblit & Hare approach. RESULTS Initially, 115 codes were identified. In the second stage, the codes were merged based on similarity and shared meanings. Finally, after checking by two authors, the following five themes were emerged: cost-effectiveness, affectivity, inefficiency of the healthcare system, previous experiences, and oversimplification. CONCLUSION The findings of this first meta-synthesis provided a comprehensive understanding of the perceptions and experiences of self-medication around the world. The findings showed that the experiences of self-medication could be classified into personal, social, organizational, and cultural categories. These findings could help policymakers address these perceptions and experiences in effective health planning.
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Affiliation(s)
- Zhila Fereidouni
- School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Majid Najafi Kalyani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Shrestha S, Poudel RS, Thapa P, Baniya S, KC B. Perception of patients towards the role of pharmacist: a cross-sectional study from selected three hospitals in Central Nepal. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2018. [DOI: 10.1111/jphs.12217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Shakti Shrestha
- Department of Pharmacy; Shree Medical and Technical College; Chitwan Nepal
| | | | - Priyanka Thapa
- Department of Pharmacy; Shree Medical and Technical College; Chitwan Nepal
| | - Susmita Baniya
- Department of Pharmacy; Shree Medical and Technical College; Chitwan Nepal
| | - Bhuvan KC
- School of Pharmacy; Monash University Malaysia; Subang Jaya Malaysia
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Practice of community pharmacists related to multivitamin supplements: a simulated patient study in Iran. Int J Clin Pharm 2017; 40:190-195. [PMID: 29270735 DOI: 10.1007/s11096-017-0579-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/13/2017] [Indexed: 01/08/2023]
Abstract
Background Multivitamin supplements are a subset of dietary supplements sold in pharmacies as over-the-counter medicines. Community pharmacists are regarded as responsible professionals and relied on for their safe practice and efficacy. Objective The aim of this study was to evaluate the counselling practices of community pharmacists relating to typical use, interactions, contraindications, and side effects of multivitamin supplements using simulated patients. Setting Ninety-seven community pharmacies in Kerman, Iran. Method Two male students acted as simulated patients who role-played a scenario in the community pharmacies in two steps. In step 1, they spontaneously mentioned they were a student and did not eat properly through lack of time and requested a multivitamin supplement. In Step 2, if the pharmacists did not request a drug history, they would explain that they had severe acne and had been taking oral isotretinoin for a month. The counselling practice of the pharmacists was audio recorded. Main outcome measure The number of pharmacists who provided information about multivitamin use and identified isotretinoin-vitamin A interaction. Results Thirteen pharmacists in charge were absent at the time of the purchases. None of the pharmacists provided information about contraindications and side effects of multivitamin products. Twenty pharmacists provided instruction for multivitamin use, and two pharmacists took a drug history. In Step 1, only two pharmacists identified isotretinoin-vitamin A interaction, but in Step 2, this number increased to 15. Conclusion The counselling practice of pharmacists should be improved to promote effective and safe use of multivitamin supplements.
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