Evaluation of medicines dispensing pattern of private pharmacies in Rajshahi, Bangladesh

BMC Health Services Research, Feb 2017

Background In developing country like BANGLADESH, people depend more on pharmacies due to expediency, shorter waiting time, cost reduction, availability of credit and flexible opening hours. The aim of this study was to investigate medicines dispensing patterns of the pharmacies in RAJSHAHI, BANGLADESH and to identify and analyze contribution of drugsellers and quacks in irrational drug use. Methods This cross-sectional study was conducted during January 2016 - April, 2016 in 75 randomly selected private pharmacies including both licensed and unlicensed pharmacies of covering LAKSHMIPUR area. Result During the whole study process, total 7944 clients visited the pharmacies under observation and 24,717 medicines were dispensed. 22.70% of all these drugs were sold without a prescription. Out of the 5610 items dispensed without prescription, 66.2% were dispensed on the request of clients themselves and 33.8% on the recommendation of a drug seller. Number of medicine in a prescription was highly variable ranging from 2 to 5 medicines per prescriptions (mean = 3.03). The average number of medicines dispensed from each of the pharmacies during the observation period was 392, varied pharmacy to pharmacy – ranging from 194 to 588. Lowest selling medicines were sedative and hypnotics and highest selling medicines were antimicrobials. The recommendation rate for antibiotics was highest for the quacks (26.48%) though the major amount of the antimicrobials (n = 3039, 65.83%) were dispensed on prescription. Macrolides, quinolones, metronidazoles and cephalosporins are most favourite drug of quacks, clients and pharmacists. Conclusion Majority of medicines were dispensed irrationally without any prescription and over the counter dispensing of many low safety profile drugs was common. The results and discussion presented in this paper will be helpful to provide a baseline to redirect further studies in this area.

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Evaluation of medicines dispensing pattern of private pharmacies in Rajshahi, Bangladesh

Saha and Hossain BMC Health Services Research Evaluation of medicines dispensing pattern of private pharmacies in Rajshahi, Bangladesh Shuvashis Saha 0 Md. Tawhid Hossain 1 0 Rajshahi Medical College, University of Rajshahi , 6002 Rajshahi , Bangladesh 1 Rajshahi Medical College Hospital , Rajshahi , Bangladesh Background: In developing country like BANGLADESH, people depend more on pharmacies due to expediency, shorter waiting time, cost reduction, availability of credit and flexible opening hours. The aim of this study was to investigate medicines dispensing patterns of the pharmacies in RAJSHAHI, BANGLADESH and to identify and analyze contribution of drugsellers and quacks in irrational drug use. Methods: This cross-sectional study was conducted during January 2016 - April, 2016 in 75 randomly selected private pharmacies including both licensed and unlicensed pharmacies of covering LAKSHMIPUR area. Result: During the whole study process, total 7944 clients visited the pharmacies under observation and 24,717 medicines were dispensed. 22.70% of all these drugs were sold without a prescription. Out of the 5610 items dispensed without prescription, 66.2% were dispensed on the request of clients themselves and 33.8% on the recommendation of a drug seller. Number of medicine in a prescription was highly variable ranging from 2 to 5 medicines per prescriptions (mean = 3.03). The average number of medicines dispensed from each of the pharmacies during the observation period was 392, varied pharmacy to pharmacy - ranging from 194 to 588. Lowest selling medicines were sedative and hypnotics and highest selling medicines were antimicrobials. The recommendation rate for antibiotics was highest for the quacks (26.48%) though the major amount of the antimicrobials (n = 3039, 65.83%) were dispensed on prescription. Macrolides, quinolones, metronidazoles and cephalosporins are most favourite drug of quacks, clients and pharmacists. Conclusion: Majority of medicines were dispensed irrationally without any prescription and over the counter dispensing of many low safety profile drugs was common. The results and discussion presented in this paper will be helpful to provide a baseline to redirect further studies in this area. Drug sells; Bangladesh; Pharmacy; Self medication; Drug policy - Background Medicines are the weapons to combat disease process but may also cause serious harm when improperly used and depending on patient’s patho-physiologic factors and pharmacologic properties of the medicine this event can be as dangerous as death. Sir William Osler said “One of the first duties of the physician is to educate the masses not to take medicine” [1]. In developing countries drug monitoring system is very poor and it is very easy to buy any drug with or without prescription [2]. This inappropriate manner of medicines dispensing is one of the key element to promote irrational use of medicine [3]. Rational use of medicine is defined by the World Health Organization as ‘when patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at affordable prices’ [4]. More than 50% of all medicines prescribed, dispensed, or sold around the globe are somehow inappropriate and at the same time 50% of patients fail to take medicines appropriately [5]. Irrational use of medicines may occur in different form but self-medication and recommendation of drug by pharmacist and quacks are the © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. most frequent forms [6]. Besides in a number of countries quality of drugs and inappropriate use of antibiotics is a growing concern [7]. From a public health viewpoint this situation needs special attention because due to these malpractices mass population become more vulnerable to excess healthcare cost, adverse drug reaction, allergic reactions, toxic poisoning, exacerbation or prolongation of critical illness, antibiotic resistance and most importantly unproductive and perilous treatment [8]. Antibiotic resistance increases cost of treatment and the poor people often have to choose between going untreated and spending huge money on drugs. BANGLADESH is the seventh most populous country in the world and population of the country is expected to be nearly double by 2050 [9]. In BANGLADESH physicians to population ratio was 1:3600 in 2011 [10]. This critica (...truncated)


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Shuvashis Saha, Md. Hossain. Evaluation of medicines dispensing pattern of private pharmacies in Rajshahi, Bangladesh, BMC Health Services Research, 2017, pp. 136, 17, DOI: 10.1186/s12913-017-2072-z