Qidwai Waris, Krishanani Mukesh Kumar, Hashmi Saman, Afridi Maria, Ali Rubina Abu
Department of Family Medicine, Aga Khan University, Karachi.
J Coll Physicians Surg Pak. 2006 Dec;16(12):743-6.
To determine the education of private drug sellers as an intervention tool in promoting rational use of medicines for diarrhoea at private drug outlets in a rural setting.
The study was conducted at Mithi, Tharparkar in rural Sindh in August 2005.
Diarrhea was selected to study drug-prescribing habit of private drug sellers. Evidence-based guidelines for control of diarrhea were developed along with simulation cases and keys. In phase-1, simulators were sent to 6 private drug sellers and their prescription was noted. After phase-1, 3 private drug sellers were educated about prescribing, while in the other 3, there was no intervention. In phase-2, simulators were sent again and prescriptions by private drug sellers was noted.
The work experience of private drug sellers was between 5 to 15 years. Two private drug sellers were employed at each of the drug outlet with education between matriculation and graduation. All the private drug sellers prescribed medicines to customers with confidence. The private drug sellers prescribed medicines to customers on a daily basis that included all categories of medications. Amoebicidals, Anti-diarrheals, antispasmodics, antibiotics, analgesics and oral rehydration solutions were prescribed by 22(38.6%), 10(17.5%), 3(4.9%), 10(17.5%), 3(5.3%) and 9(15.8%) private drug sellers prior to intervention respectively. It changed to 0(0%), 6 (14%), 0(0%) 0 (0%), 4 (9.3%) and 16(37.2%) postintervention respectively. Referral to hospital for serious cases increased after intervention.
The rational use of medicines can be promoted by providing education to private drug sellers. Further studies and education programs for private drug sellers are strongly recommended across the country.
确定对个体药品销售商进行培训，以此作为一种干预手段，促进农村地区个体药店合理使用腹泻治疗药物。
2005年8月在信德省农村地区的塔尔帕卡尔县米蒂开展了此项研究。
选择腹泻病来研究个体药品销售商的开药习惯。制定了腹泻病控制的循证指南以及模拟病例和答案。在第一阶段，向6名个体药品销售商发放模拟病例，记录他们开出的处方。第一阶段结束后，对3名个体药品销售商进行了开药培训，另外3名则未进行干预。在第二阶段，再次向个体药品销售商发放模拟病例，并记录他们开出的处方。
个体药品销售商的工作经验在5至15年之间。每个药店有两名个体药品销售商，其受教育程度在高中和大学毕业之间。所有个体药品销售商都自信地为顾客开药。个体药品销售商每天都会为顾客开药，所开药品包括各类药物。干预前，22名（38.6%）、10名（17.5%）、3名（4.9%）、10名（17.5%）、3名（5.3%）和9名（15.8%）个体药品销售商分别开具了抗阿米巴药、止泻药、解痉药、抗生素、镇痛药和口服补液盐。干预后，这一比例分别变为0（0%）、6名（14%）、0（0%）、0（0%）、4名（9.3%）和16名（37.2%）。干预后，重症病例转诊至医院的情况有所增加。
通过对个体药品销售商进行培训可促进合理用药。强烈建议在全国范围内针对个体药品销售商开展进一步研究和培训项目。
