Extent of dispensing prescription-only medications without a prescription in community drug retail outlets in Addis Ababa, Ethiopia: a simulated-patient study.
Extent of dispensing prescription-only medications without a prescription in community drug retail outlets in Addis Ababa, Ethiopia: a simulated-patient study.
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DOI：
10.2147/dhps.s106948
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Gebresillassie BM
中科院分区：
文献类型：
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作者：
Erku DA;Mekuria AB;Surur AS;Gebresillassie BM
本研究旨在评估埃塞俄比亚阿迪斯社区药品零售点（CDRO）中仅凭处方配药而无需处方的程度。采用描述性横断面观察性研究设计，通过简单随机抽样方法，于2015年8月11日至2015年10月21日对31家药店、25家药店和2家农村药品供应商进行抽样。采用模拟患者访视方法收集数据。选择6种示踪处方药物（阿莫西林+克拉维酸胶囊、阿米替林、卡托普利、格列本脲[也称为格列本脲]、奥美拉唑胶囊和枸橼酸西地那非）的要求和上呼吸道感染作为模拟临床场景。阿莫西林-克拉维酸胶囊按需发放率为87.93%。所有CDRO均应要求分发奥美拉唑。枸橼酸西地那非（伟哥）在96.55%的CDRO中有库存，所有这些CDRO都发出了所需数量的片剂，而没有询问为什么或谁需要这种药物。在提供空容器时，阿米替林、卡托普利和格列本脲（格列本脲）分别在84.48%、89.65%和87.93%的CDRO中分发。75.86%的CDRO因上呼吸道感染症状而使用抗生素。处方中最常见的是阿莫西林（93.18%），其次是阿莫西林克拉维酸胶囊（72.72%）和阿奇霉素（50%）。只有4.5%的药房询问药物过敏，15.9%的CDRO告知模拟患者药物可能的副作用。这项研究表明，在没有处方的情况下，仅凭处方配药的比例非常高。几乎所有随机抽样的CDRO都可以轻松获得抗菌药物和慢性病药物。必须实施良好的配药做法，并遵守有关的现行国家法律和法规。还必须采取强有力和明确的行动方针，特别是针对抗生素的不合理使用。
This study was aimed at assessing the extent of dispensing prescription-only medications without a prescription in community drug retail outlets (CDROs) of Addis Ababa, Ethiopia. A descriptive cross-sectional observational study design was used to sample 31 pharmacies, 25 drug stores, and two rural drug vendors from August 11, 2015, to October 21, 2015, through a simple random sampling method. A simulated-patient method of visit was implemented to collect data. Requests of six tracer prescription-only medicines (amoxicillin + clavulanic acid capsule, amitriptyline, captopril, glibenclamide [also known as glyburide], omeprazole capsule, and sildenafil citrate) and upper respiratory tract infection were selected as the simulated clinical scenario. Amoxicillin–clavulanic acid capsule was dispensed when requested in 87.93% of the dispensaries. All of the CDROs dispensed omeprazole upon request. Sildenafil citrate (Viagra) was in stock in 96.55% of the CDROs, all of which issued the requested number of tablets without asking why or for whom the drug was needed. Amitriptyline, captopril, and glibenclamide (glyburide) were dispensed in 84.48%, 89.65%, and 87.93% of CDROs upon the provision of an empty container. Antibiotics were obtained from 75.86% of CDROs for presentation of upper respiratory tract infection symptoms. Among the dispensed antibiotics, the most common was amoxicillin (93.18%), followed by amoxicillin–clavulanic acid capsule (72.72%), and azithromycin (50%). Only 4.5% of the dispensaries asked about drug allergies, and 15.9% of the CDROs informed the simulated patient about the possible side effects of the drugs. This study revealed a very high rate of dispensing of prescription-only medicines without a prescription. Antimicrobials and drugs for chronic diseases were obtained with ease from almost all of the randomly sampled CDROs. Putting good dispensing practice into effect and adhering to the existing national laws and regulations regarding the same are necessary. It is also necessary to adopt a strong and explicit line of action, especially toward the irrational use of antibiotics.