Assessment of prescribing errors reported by community pharmacy professionals.

BACKGROUND: Medication errors have serious consequences for patients' morbidity and mortality. The involvement of pharmacy professionals in the prescribing and dispensing procedure allowed the detection of a range of drug-related problems in addition to identification by prescribers. They are often the first point of contact in the healthcare system in identifying prescribing errors and intervening in these errors by dealing with the prescribers and the patients. OBJECTIVES: This study aimed to assess prescribing errors reported by community pharmacy professionals in Gondar Town, North West Ethiopia. METHODS: A self-administered cross-sectional survey was employed from February 29 to June 23, 2020, to collect data on prescribing errors reported by community pharmacy professionals. All community pharmacy professionals found in Gondar town were included. Community pharmacy professionals who were ill at the time of study and who had less than 6 months of work experience were excluded. RESULTS: Seventy-four pharmacy professionals participated in the study with a response rate of 93.6%. The overall prevalence of prescribing errors was 75.1% (95% CI 71.08-78.70). Of these errors, drug selection was the most common (82.4%), followed by errors of commission (79.7%) and errors of omission (78.4%). Antibiotics (63.5%) were commonly involved in prescribing errors, followed by analgesics (44.5%) and antipsychotics (39.5%). CONCLUSION: The findings of this study revealed a high prevalence of prescribing errors in Gondar, Ethiopia. Drug selection was the most prescribed error, followed by errors of commission. Stakeholders should design interventions such as training, integrating prescribers with clinical pharmacists and supervising interns by seniors. Large-scale studies that include potential factors of prescribing problems are recommended for future researchers.

Assessment of Community Pharmacy Professionals' Attitude and Perception Towards Ethical Issues in Amhara Region, Ethiopia: A Cross-Sectional Survey 2020.

PURPOSE: The objective of this study was to assess the attitude and perception of community pharmacy professionals' towards ethical issues. METHODS: We have undertaken a cross-sectional study among community pharmacy professionals in three selected towns (Gondar, Bahir Dar, and Debra Markos) of Amhara region in Ethiopia from February to March 2020. All community pharmacy professionals who were giving services during the data collection period were the study population. We used a pretested, semi-structured questionnaire developed from a review of previous study. Epi-info 7.1 was used for data entry, and SPSS version 20 was used for data analysis. Logistic regression was done, and a variable with a p-value < 0.05 with 95% confidence interval was considered to be associated with outcome variable. RESULTS: A total of 305 community pharmacy professionals participated in the study with a response rate of 95.3%. About 252 (82.6%) of respondents received education regarding professional ethics. Majority (89.8%) of the participants had ever accessed ethical information at their work site. Only 145 (47.5%) participants had ever recorded ethical issues in their working site. The most common reasons that obstruct to explain ethical issues to customers were shortage of time (85.9%), unavailability of reliable resources (40.0%), and poor ethical knowledge (37.7%). The reporting rate of respondents is less than 50% for most ethical scenarios. Sex, age, educational status, work experience, number of customers per day, working site, information about ethics, and training about ethics were observed to have a significant association with attitude and perception of community pharmacy professionals towards ethical issues. CONCLUSION: Community pharmacy professionals had poor attitude and perception towards ethical issues. Interventions should be devised to uphold ethical awareness of community pharmacy professionals. A large-scale study is also recommended.

Knowledge, Prevention Practice and Associated Factors of Stroke Among Hypertensive and Diabetic Patients - A Systematic Review.

INTRODUCTION: Because of the inadequate level of public awareness of the disease, the incidence of stroke has been sharply rising. Eventually, due to the prehospital delay, many stroke cases could not be eligible for thrombolysis thereby poor rehabilitative outcome has been tremendously increased. Thus, this study aimed to review the level of knowledge, prevention practice, and associated factors of stroke among hypertensive and diabetic patients. METHODS: A systematic review of primarily published articles (2010-2020) related to knowledge and prevention practices of stroke was performed by searching online electronic databases like PubMed, Google Scholar, Refseek, Science direct, ResearchGate, and manual Google search by using the keywords and MeSH terms. Studies conducted on knowledge and prevention practices amongst hypertensive and/or diabetic patients were included. RESULTS: Out of 531 searched studies, 42 articles were identified to be reviewed. The reported overall knowledge of stroke was ranging from 4.4% to 79%. Knowledge to the signs/symptoms of stroke was 23.6% to 87%. However, 15% to 77% of subjects were also reported that they did not know any sign of stroke. The range of risk factor knowledge was 10.5% to 86.6%. The reported level of stroke prevention practice was 2.4% to 72% but physical activity and weight reduction practice were relatively low. Inadequate level of knowledge and prevention practice of stroke was related to elderly, female gender, uneducated, unmarried, rural residents, economically low, comorbidity and unemployed individuals. CONCLUSION: The current finding revealed that the level of knowledge and prevention practice of stroke was inadequate. Hence, the finding highlights health educational programs should be planned as an important avenue to enhance stroke awareness among the high-risk populations.

History taking and response to an adult diarrheal case among community drug retail outlets in Gondar town, north-west Ethiopia: a simulated-client survey.

BACKGROUND: Self-care is one of the growing tasks of community pharmacy professionals. They are highly engaged in consultations in response to specific drug request (product-based presentation) or symptoms clients describe (symptom-based presentation). PURPOSE: This study was aimed at assessing the appropriateness of patient assessment and response to an adult diarrheal case among community drug retail outlets in Gondar town, north-west Ethiopia. METHODS: A descriptive cross-sectional study design based on simulated-client method of visit was conducted from 03 August to 21 September, 2020. An adult female diarrheal case scenario was developed and used to guide data collectors to interact with professionals in a standardized and consistent way. All 60 dispensaries in the town during the data collection were included in the study. A pretested data collection tool was used to record the conversation between simulated clients and providers. The data were analyzed using SPSS version 20. RESULTS: With regard to patient history, age of the patient, whether diarrhea is watery or bloody and onset and duration of diarrhea were the three most commonly requested questions with 59 (98.3%), 55 (91.7%) and 46 (76.7%), respectively. Past-medical and medication history are enquired in none of the visits. Medication was dispensed in 57 (95%) of the visits and no referral to a health facility was recommended in majority (90%) of cases. The most commonly recommended medications were ciprofloxacin 30 (52.6%) and metronidazole 20 (35.1%). ORS was considered in only 6 (10.5%) dispensaries. CONCLUSION: Patient assessment, final decisions and treatment recommendations for an adult diarrheal case are inadequate, irrational and illegal. Educational interventions coupled with incentive mechanisms for cognitive pharmaceutical service and strict regulatory enforcement are needed to reduce the problem.

Pattern and predictors of medicine use among households in Gondar Town, northwestern Ethiopia: a community-based medicine utilization study.

BACKGROUND: Medicine use can be influenced by several factors. Health managers need specific information about irrational use of medicines, in order to identify opportunities to enhance rational use of medicines in their communities. This study aimed to assess the pattern and factors associated with household medicine use in Gondar town, northwestern Ethiopia. METHODS: An interviewer-administered cross-sectional survey was conducted on 771 households, carried out between 5 April and 6 May 2015. The questionnaire contained items focusing on different aspects of medicine use in the households. The analysis involved descriptive summary and binary logistic regression test, which assessed association of independent variables with medicine use. RESULTS: Of the households interviewed, 22.4% (173/771) disclosed the presence of at least one chronic disease in the family; while 49.2% reported the use of medicine in the one month prior to the study. Almost all of the households (92.6%) reported a habit of discontinuing medicines, and 17.8% disclosed a practice of sharing medicines with household members and others. Level of education, presence of health professionals, and individuals with chronic illness in the households were linked to increased likelihood of reporting medicine use. Discarding leftover medicines with garbage (56.7%) was the principal means of disposal reported by the households. CONCLUSIONS: A high proportion of reported medicine use, together with problems such as sharing with other people and leaving medicines unfinished were found among the households in the study.

A household survey of medicine storage practices in Gondar town, northwestern Ethiopia.

BACKGROUND: Household surveys are crucial to get accurate information on how medicines are acquired, and used by consumers, as they provide the best evidence in the area. The objective of this study was to document household medicine storage practices in Gondar town, northwestern Ethiopia. METHODS: A cross-sectional household survey was conducted from April 5 to May 6, 2015. In the study, 809 households were surveyed from four sub-cities in the town selected through multistage sampling with 771 included in the final analysis. Data on the extent of storage, storage conditions, sources of medicines and their current status among others were collected through structured interviews and observations. The data were entered in to Epidata version 3.1, exported to and analyzed using Statistical Packages for Social Sciences (SPSS) version 21. RESULTS: Of the 771 households in the study, 44.2% stored medicines. Presence of family members with chronic illness(es) and higher levels of household incomes predicted higher likelihood of medicine storage. In the households which allowed observation of stored medicines (n = 299), a mean of 1.85 [SD = 1.09] medicines per household were found. By category, anti-infectives for systemic use (23.9%), medicines for alimentary tract and metabolism (19.2%) and those for cardiovascular system (17.7%) ranked top. Among individual medicines stored, diclofenac (10.7%), paracetamol (9.9%) and amoxicillin (8.0%) were on top of the list. Dispensaries (97.8%) and physicians (83.5%) were almost exclusive sources of medicines and advices/orders for medicines respectively. Nearly two-thirds of the medicines found were on use and a vast majority (76.5%) were stored in chests of drawers. Proportion of expired medicines was very low (3.14%). CONCLUSIONS: The use of physicians' and pharmacists' advice to get medicines; use of dispensaries as principal sources, large proportion of medicines being in use and very low proportion of expiry showed good practices. However, storage places of medicines were not purpose built. Encouraging good practices through continued medicine use education and advocating appropriate medicine storage in medicine cabinets is required to improve storage conditions and consequent use of medicines.