Herbal Medicine (HM) among pharmacy professionals working in drug retail outlets in Asmara, Eritrea: knowledge, attitude and prevalence of use.

BACKGROUND: Globally, the usage of herbal medicines (HMs) is increasingly growing in treating and preventing various ailments. Although, HMs play a vital role in healthcare, concerns have been raised over their safety. Since pharmacy professionals are at the right position to provide patients with evidence-based information on herbals, they should be knowledgeable enough on the subject matter. Thus, the aim of the study was to assess the knowledge, attitude and prevalence of HMs use and its associated factors among pharmacy professionals. METHOD: An analytical cross-sectional study was conducted among pharmacy professionals working in drug retail outlets in Asmara (the capital city of Eritrea). A census design was employed and data were collected through face-to-face interview. Data were entered and analyzed using Census and Survey Processing System (version-7.2) and IBM Statistical Package for Social Sciences (version 26), respectively. Descriptive and analytical statistics including Mann-Whitney U test/Kruskal-Wallis test and logistic regression were employed. P-values less than 0.05 were considered as significant. RESULTS: A total of 50 pharmacy professionals (90.9% response rate) were enrolled in the study. Majority of them (62%) were males and two-thirds had a bachelor's degree. The overall median (Interquartile range, IQR) knowledge score was found to be 24 (12.16) out of 100 with a minimum score of 8 and maximum score of 53. Generally, the median (IQR) attitude score was 70.4 (4.2) out of 100. Majority (78%) of them had used HM for self-treatment. Only religion was found to be a significant determinant of knowledge on indication of HMs (p = 0.015), while attitude score was independent of the potential determining factors. Moreover, prevalence of use was significantly associated with pharmacy ownership (Adjusted Odds Ratio (AOR) =14.44, 95%Confidence Interval (CI): 1.67, 124.52) as well as with the percentage attitude score (AOR = 0.632, 95%CI: 0.41, 0.96) at multivariable level. CONCLUSION: Generally, the overall knowledge score of pharmacy professionals was low. However, they possessed positive attitude towards herbal medicines. Besides, there was prevalent usage of herbal medicine for self-treatment. This outcome triggers the need for educational courses and workshops centered on herbal medicine.

Drug prescribing and dispensing practices in regional and national referral hospitals of Eritrea: Evaluation with WHO/INRUD core drug use indicators.

Rational use of medicine (RUM) for all medical conditions is crucial in attaining quality of healthcare and medical care for patients and the community as a whole. However, the actual medicine use pattern is not consistent with that of the World Health Organization (WHO) guideline and is often irrational in many healthcare setting, particularly in developing countries. Thus, the aim of the study was to evaluate rational medicine use based on WHO/International Network of Rational Use of Drugs (INRUD) core drug use indicators in Eritrean National and Regional Referral hospitals. A descriptive and cross-sectional approach was used to conduct the study. A sample of 4800 (600 from each hospital) outpatient prescriptions from all disciplines were systematically reviewed to assess the prescribing indicators. A total of 1600 (200 from each hospital) randomly selected patients were observed for patient indicators and all pharmacy personnel were interviewed to obtain the required information for facility-specific indicators. Data were collected using retrospective and prospective structured observational checklist between September and January, 2018. Descriptive statistics, Welch's robust test of means and Duncan's post hoc test were performed using IBM SPSS (version 22). The average number of medicines per prescription was 1.78 (SD = 0.79). Prescriptions that contained antibiotic and injectable were 54.50% and 6.60%, respectively. Besides, the percentage of medicines prescribed by generic name and from an essential medicine list (EML) was 98.86% and 94.73%, respectively. The overall average consultation and dispensing time were 5.46 minutes (SD = 3.86) and 36.49 seconds (SD = 46.83), respectively. Moreover, 87.32% of the prescribed medicines were actually dispensed. Only 68.24% of prescriptions were adequately labelled and 78.85% patients knew about the dosage of the medicine(s) in their prescriptions. More than half (66.7%) of the key medicines were available in stock. All the hospitals used the national medicine list but none of them had their own medicine list or guideline. In conclusion, majority of WHO stated core drug use indicators were not fulfilled by the eight hospitals. The results of this study suggest that a mix of policies needs to be implemented to make medicines more accessible and used in a more rational way.