Comparison of the Knowledge and Practices in Medicine Dispensing between Retail Medicine Shops and Model Pharmacies in Dhaka Metropolis

Model pharmacy has been adopted recently to upgrade the healthcare delivery system in Bangladesh. This study was aimed to analyze and compare the effectiveness of drug dispensing patterns, practices, and knowledge of both clients and dispensers of model pharmacies over traditional retail medicine shops. Two established methods, namely, client simulated method (CSM) and provider interview method (PIM), were employed to determine the practice differences in 90 retail medicine shops and 90 model pharmacies in and around Dhaka city. The results are represented primarily in comparison with corresponding percentages. The survey results did not fully support the findings obtained from the observations of the CSM as PIM contrasted these to some extent, and the differences are statistically significant ( p < 0.0001 ). According to CSM, the presence of A-grade pharmacists during working hours in retail medicine shops was 0%, and 63% in model pharmacies. As reported by PIM, in the retail medicine shops, 36% of clients were ignorant of visiting doctors before purchasing medicine. On the other hand, only 18% of clients could visit doctors. As per CSM, 40% of clients did not follow doctors' recommendations for completion of the full dose of antibiotics bought from retail medicine shops and 51% did not finish full antibiotic courses collected from model pharmacies. Additionally, CSM revealed that 28% of the clients administered leftover drugs following old and obsolete prescriptions of retail medicine shops and 21% of clients followed the same practices in terms of model pharmacies. The report of CSM revealed that 95% of dispensers of retail medicine shops sold medicine without prescription except over-the-counter (OTC), and in the model pharmacies, the percentage was 77%. The qualitative findings revealed substandard practices and dispensing pattern too. Model pharmacies were established to prevent aberrant medicine dispensing patterns and ensure proper medication dispensing practices and medicine intake. This research could not verify the situation that pharmacists or owners of model pharmacies were fully abiding by the guidelines set for them by the Directorate General of Drug Administration (DGDA).

A Study on the Dispensing Pattern of OTC Medications in Community Pharmacies: Generic versus Non-Generic drugs

Over the Counter (OTC) Drugs are legally allowed to be sold 'Over the Counter' without the prescription of a registered medical practitioner (RMP). The study aimed to assess the drug dispensing pattern of the commonly dispensed category of OTC drugs, understand the patient's knowledge using a self-designed questionnaire and to compare the cost-effectiveness based on the unit price of drugs between generic and non-generic drugs. A prospective observational study was conducted from November 2018 to April 2019 in randomly selected licensed community pharmacies in Banashankari, Bengaluru (3 private pharmacies and 1 government-sponsored pharmacy). Data collected was documented and analyzed using Microsoft Excel and Z test. 59.33% (non-generic) & 24.67% (generic) pharmacists had collected the clinical history before dispensing the drugs. Non-generic pharmacists (62.00%) provided adequate information about the dispensed drug than generic pharmacists (30.00%). The frequently dispensed OTC drugs were analgesics and antipyretics and commonly reported illness was a pain. Consumers had an opinion that the usage of OTC drugs was safe and was not aware of the side effects. Patient counselling was given to 82% of the consumers in generic and 43% in non-generic pharmacies regarding their health issue and medications. Generic drugs were more cost-effective than non-generic drugs.

Pattern and probability of dispensing of prescription opioids and benzodiazepines among the new users in Australia: a retrospective cohort study

ObjectiveOpioids and benzodiazepines are recommended to use for a short duration. Clinicians face a challenge to appraise the risk of new users to become long-term users. This study examined the pattern and probability of opioids and benzodiazepines dispensing among the new users.DesignA unit-record data of an incident and a point-incident cohort of new users, who were not dispensed in the previous 2 years, was examined and retrospectively followed up for 24 months.SettingAustralia.ParticipantsA random 10% national sample.Primary and secondary outcome measuresDistribution of total dispensing in calendar months. Probability of staying in the cohort in each successive month. Effect of first month’s dispensing pattern on the total duration of dispensing during 2nd–24th month in total number of calendar months the dispensing was recorded.ResultsIn the incident cohort, 68.24% were dispensed opioids, 23.96% were dispensed benzodiazepines and 7.80% were dispensed both medicines. Over 70% in the incident cohort and 50% in the point-incident cohort were dispensed for a month only. Codeine was the most prevalent opioid, dispensed to 52% of opioid users; and diazepam was the most prevalent benzodiazepines, dispensed to 45.34% of benzodiazepine users. The probability of staying in the cohort and hence receiving further dispensing continued to be very high if dispensing did not end in the first month. The quantity (in defined daily dose) and the total number of dispensing episodes in the first month were significant predictors of the total duration of dispensing in the later period.ConclusionsSince harms from long-term use of these medicines may outweigh the benefits, and since the probability of further dispensing was high for those who were dispensed for more than a month, clinicians should endeavour to keep the dispensing duration and quantity as small as possible while initiating a prescription for the new users.