Assessing Compliance to the Standards of Dispensing Practices in Community Pharmacies in Nima

Abstract

Introduction: Dispensing is one of the important activities that take place in an everyday community pharmacy setting. It starts with receipt and confirmation of prescription order, examination and interpretation of prescription, verification and consultation if required, removal of medicines for final checks and issuance of medicines with clear instructions and counselling. Good dispensing practices are therefore vital and guarantee that the right patient receives an effective form of the correct drug, with right dosage and quantity written in clear instructions, in well-labelled packages, which maintains the integrity of medicines. The rate of medication compliance is directly influenced by the accuracy of labelling shown by dispensers, the time spent in counselling patients and the skills exhibited in communicating with patients. Objective: The aim of this study is to assess compliance to the standards of dispensing practices in community pharmacies in Nima. Method: A descriptive cross sectional study was conducted among the six existing and operational community pharmacies in Nima. The study population covered 26 dispensers in the community pharmacies and 394 clients exiting these facilities. A conservative sampling method was used to obtain the sample size of patients recruited for the study and two different structured questionnaires were used to collect data from both the patients and the dispensers. Assessment was made by direct observation of the dispensing practices and through a face-to-face exit interview of patients to determine compliance to the standards of labelling, counselling and dispensing time. Data was exported from Excel to STATA which were processed and analyzed. Results: From the study, an average of four labelling indicators were provided on drug labels by dispensers out of the 10 indicators for the labelling checklist. These were dosage of drug representing 98.48%, name of drug (93.15%), expiration date (80.96%), and cautionary information (59.14%). A general assessment of the standards of labelling in Nima community pharmacies indicated a 9.1% level of compliance as against the checklist of 100%. The majority of clients were also provided with only four patient counselling information out of the 12 counselling indicators which were dosage instruction (96.45%), instruction on whether the medication was to be taken with food or on an empty stomach (72.34%), duration of medication (67.51%) and purpose of medication (59.39%). The proportion of efficient counselling presented by the community pharmacies in Nima to the patients was 20.6% and the proportion of non-compliance to counselling standards was 79.4%. Furthermore, it was observed that 36.55% of the dispensing occurred from 5 min and above which corresponds to adequate dispensing time. Conclusion: Generally, compliance to the standards of dispensing practices in Nima Community Pharmacies are poor and below international standards as the proportion of compliance to standards of dispensing practices was 8.6% and the proportion of non-compliance to the standards of dispensing practices was 91.4%. This therefore demand serious regulations and policies to be implemented in order to ensure and improve on dispensing practices.