ABSTRACT
OBJECTIVE: In today's context of globalisation of pharmaceutical production and distribution, international and national procurement agencies play a de facto key role in defining the quality of medicines available in sub-Saharan Africa. We evaluated the compliance of a sample of pharmaceutical distributors active in sub-Saharan Africa with the standards of the WHO guideline 'Model Quality Assurance System (WHO MQAS) for procurement agencies', and we investigated factors favouring or hindering the adequate implementation of the guideline. METHODS: We used mixed-methods methodology to analyse quantitative and qualitative data. The quantitative study consisted of a retrospective secondary analysis of data collected by QUAMED (Quality Medicines for all), a partnership that pleads for universal access to quality-assured medicines. The qualitative survey consisted of formal and informal interviews with key informants. We adopted an embedded multiple-case study design. FINDINGS: Our analysis suggests that international distributors based in Europe perform, on average, better than sub-Saharan African distributors. However, some weaknesses are ubiquitous and concern critical processes, such as the initial selection of the products and the ongoing reassessment of their quality. This is due to several different factors: weak regulatory oversight, insufficient human/financial resources, weak negotiating power, limited judicial autonomy and/or lack of institutional commitment to quality. CONCLUSIONS: Our findings suggest that pharmaceutical distributors active in sub-Saharan Africa generally do not apply stringent criteria for selecting products and suppliers. Therefore, product quality is not consistently assured but depends on the requirements of purchasers. While long-term solutions are awaited, the WHO MQAS guideline should be used as an evaluation and training tool to upgrade current standards.
ABSTRACT
Objetivo: Valorar y cuantificar el grado de satisfacción de los pacientes respecto al trato y la información que reciben en la unidad de pacientes externos de un hospital. Método: Estudio descriptivo de corte transversal, desarrollado durante 2 meses en pacientes ambulatorios mayores de 18 años que han querido participar. Para registrar el grado de satisfacción de los pacientes se ha utilizado un cuestionario autoadministrado, semiestructurado y validado. Resultados: En total se ha entrevistado a 81 pacientes, 46 hombres y 35 mujeres. Un 91,1% de los pacientes valora positivamente el interés que mostró el personal durante la dispensación. Un 82,2% afirma haber recibido la información adecuada de los medicamentos. Un 67,1% indica haber aprendido a conocerlos medicamentos. Un 72% de los pacientes afirma haber recibido la información necesaria como para valorar importante la adherencia a los fármacos, aunque sólo un 55% indica conocer sus efectos secundarios. La satisfacción con el servicio de farmacia en general resulta ser de un 97,3%. Conclusiones: El grado de satisfacción y de confianza de los pacientes ambulatorios con el servicio de farmacia es alto, ya que la mayoría se muestran satisfechos con el trato recibido y aprecian la diligencia de los profesionales implicados; sin embargo, es necesario mejorar el proceso de educación sanitaria, ya que casi un 30% no está satisfecho con la información recibida sobre los efectos adversos potenciales (AU)
Objective: To assess and quantify the patients' degree of satisfaction relative to the treatment and information they receive in a hospital outpatient unit. Method: Descriptive, cross-sectional study, developed during two months in outpatients over 18 years old, who wanted to participate.In order to record the patients' degree of satisfaction, a self-administered, semi-structured and validated questionnaire has been administered. Results: A total of 81 patients were interviewed, being 46 male and 35 female. 91.1% of the patients have a positive assessment of the interest shown by the staff during dispense. 82.2% state to have received the suitable information about the medications. 67.1% confirmed they learned to know their medications. 72% of the patients state to have received the necessary information to assess the importance of adhesion to the medicines, although just 55% confirms knowing the medicine adverse effects. The result of satisfaction with the pharmacy in general is 97.3%. Conclusions: The outpatients' degree of satisfaction and confidence with the pharmacist service is high, since most of the mare satisfied with the treatment received and appreciate the diligence of the professionals involved; however, it is necessary to improve the health education process as nearly 30% are not satisfied with the information received about the potential adverse effects (AU)
